Kornimate/medical-research-clean huggingface dataset:
a randomized trial evaluating early application of a surfactant dressing in thermal injury (early)

Conditions: Burns; Partial-thickness Burn

Summary: the purpose of this study is to test the following hypotheses: 1. early use of water-soluble surfactant dressing (wsd) on partial-thickness burn wounds will result in tissue salvage and reduce surgical burden. 2. early use of wsd on partial-thickness burn wounds will result in faster healing. 3. use of wsd on partial-thickness burn wounds will result in less painful wound care. 4. early use of wsd on partial-thickness burn wounds will result in less infection. 5. early use of wsd on partial-thickness burn wounds will result in lower hospital costs.

surfactant-based wound dressings have been utilized in chronic, non-healing wounds and small burn wounds to soften and aid removal of wound debris. in vitro data suggest enhanced healing properties are due the ability to stabilize and potentially reseal plasma membranes, thereby, retaining cellular integrity and enhance wound healing. improved cellular viability and functionality has also been established in heat-shock, ionizing radiation, and electrical injury models. in one rat model, topically suffused mesentery demonstrated improved microvascular flow and reduction in the number of abnormally flowing microvessels following thermal injury. intravenous administration has been studied in several disease states. in thermal injury, intravenous administration has shown potential to improve blood flow and reduce the zone of coagulation. further, surfactant-based wound dressings are non-ionic and may facilitate removal, sensitize, or prevent bacterial biofilms. biofilms are an evolved, protective mechanism bacteria utilize to reduce antimicrobial efficacy. removal or penetration of biofilms is essential for bacterial eradication. there is little evidence demonstrating the efficacy of early use of a wsd for treating partial-thickness burn wounds.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years old * admitted within 24 hours of injury * partial-thickness burn wounds on at least two non-contiguous areas of \< 10% tbsa each and not involving face, fingers, toes, and perineum * initial management assessed to require inpatient care exclusion criteria: * chemical, electrical, or inhalation injury * pregnant * incarcerated * tbsa ≥ 20% * wound expected to heal within 7 days * patient or authorized representative unable or unwilling to consent * unable to consent within 24 hours of injury

Keywords: early randomized clinical trial surfactant dressing total body surface area outcome assessment thermal burn injuries
effect of a robotic platform for hip fracture rehab

Conditions: Hip Fractures

Summary: hip fracture is one of the most common traumas associated with falls in the elderly, severely affecting the patient's mobility and independence. the treatment involves hospitalization and prolonged rehabilitation periods with high costs which are associated with an increased mortality rate due to health complications. in recent years, the use of robotic applications has proven to be effective in gait rehabilitation, especially for neurological disorders. however, there is a lack of research in robotic rehabilitation focused on the hip fracture of elderly people. this study presents the validation of a novel robotic platform for hip rehabilitation called swalker aimed at improving the rehabilitation of this condition in comparison with conventional rehabilitation.

the performance of the swalker platform was assessed at albertia servicios sociosanitarios s.a. nursing homes. clinical validation was conducted with hip fracture patients. the control group consisted of patients who followed conventional therapy, while the intervention group consisted of patients rehabilitated using swalker. allocation to groups was according to the choice of the participants. all patients had the possibility to use swalker treatment. physiological parameters, and functional assessment scales such as fac and tinetti were collected at the beginning and at the end of the intervention. gait recovery and rehabilitation process indicators were also gathered. the total duration of the clinical validation was 15 months. for each patient, the total duration of treatment was between 1 week and 1 month with the robotic platform. for those patients who received conventional rehabilitation, treatment duration was up to 6 months in the most severe case. patient follow-up was conducted in parallel with the clinical trials.

Eligibility criteria:
inclusion criteria: * patients who, after recently having undergone a hip fracture surgery, needed subsequent rehabilitation to restore autonomous ambulation * patients over 65 years of age exclusion criteria: * patients who have undergone a hip fracture surgery more than 5 months ago * patients who have already received other types of hip fracture rehabilitation therapies * patients with advanced and limiting neurological and cognitive impairment
the utility of timed segmental withdrawal during screening colonoscopy

Conditions: Colonoscopy

Summary: the purpose of colonoscopy (colon examination with flexible tube and a camera) is to find early precancerous growth in the colon (polyps) and remove them before they turn into cancer. the doctor performing the procedure will first advance the colonoscope to the end of the colon (cecum) and then he will examine the colon for polyps while he is withdrawing the colonoscope. the period of time that the doctor spent examining the colon called "withdrawal time". usually doctors will spend at least 6 minutes examining the colon after he reached the cecum. the investigators are proposing that dedicating half of the withdrawal time during colonoscopy in examining the right side of the colon, will increase the detection of polyps in the right side of the colon.

research design: this is a prospective, randomized trial comparing the adr between patients undergoing a screening colonoscopy in four different groups: 1) at least 3 minutes from the total withdrawal time dedicated to the right side of the colon, 2) at least 4 minutes from the total withdrawal time dedicated to the right side of the colon, 3) 6 minutes total withdrawal time regardless of time spent in any segment, 4) 8 minutes total withdrawal time regardless of the time spent in any segment. randomization will be done in blocks after stratification. four gastroenterologists and two fellows matched base on similar adr and stratified on each arm of the study (segmental versus non-segmental withdrawal) will be performing the procedures. the estimated sample size of the four arms of the study is 400 patients.

Eligibility criteria:
inclusion criteria: * adults undergoing colonoscopy for screening or surveillance purposes exclusion criteria: * prior history of colonic surgeries * crohn's colitis or ulcerative colitis * prior history of colon cancer * poor bowel preparation * pregnancy

Keywords: screening colonoscopy surveillance colonoscopy
digital capillary refill for monitoring of sepsis

Conditions: Sepsis

Summary: observational study for monitoring of capillary refill time in sepsis

this is an observational studying assessing changes in capillary refill time over the course of sepsis treatment.

Eligibility criteria:
inclusion criteria: 1. clinical evidence of a known or suspected infection and orders written for administration of iv antibiotics 2. hypotension as defined by the need for any vasopressor (and 1 liter of fluid already administered) or respiratory failure defined by assisted ventilation (includes mechanical ventilation and bipap), cpap, or greater than or equal to 6 liters/minute of supplemental oxygen exclusion criteria: 1. no consent/inability to obtain consent from the participant or a legally authorized representative 2. diagnosis of cirrhosis by medical chart review 3. liver transplant recipient 4. ast or alt greater than five times upper limit of normal 5. diagnosis of ongoing chronic alcohol use disorder/abuse by chart review; if medical record unclear, use appendix f 6. clinical diagnosis of diabetic ketoacidosis or other condition such as profound hypoglycemia that requires hourly blood glucose monitoring 7. hypersensitivity to acetaminophen or vitamin c 8. patient, surrogate or physician not committed to full support (exception: a patient will not be excluded if he/she would receive all supportive care except for attempts at resuscitation from cardiac arrest) 9. home assisted ventilation (via tracheotomy or noninvasive) except for cpap/bipap used only for sleep-disordered breathing 10. current active kidney stone 11. known history of oxalate kidney stones or history of oxalate nephropathy 12. kidney transplant recipient 13. use of home oxygen for chronic cardiopulmonary disease 14. moribund patient not expected to survive 24 hours 15. underlying malignancy or other condition with estimated life expectancy of less than 1 month 16. pregnant woman, woman of childbearing potential without a documented negative urine or serum pregnancy test during the current hospitalization, or woman who is breast feeding 17. prisoner 18. enrollment in another critical care based pharmacologic interventional trial 19. treating team unwilling to enroll because of intended use of acetaminophen or vitamin c
expression of molecular markers before and after neo-adjuvant chemoradiotherapy in rectal cancer

Conditions: Rectal Cancer

Summary: the purpose of this study is to determine whether markers on tumor tissue may be an indicator for good response to neoadjuvant chemoradiotherapy in patients with rectal cancer.


Eligibility criteria:
inclusion criteria: * locally advanced rectal cancer ut3 or ut4 * no distant metastasis * neoadjuvant radiochemotherapy required exclusion criteria: * rejection of radiochemotherapy

Keywords: rectal cancer with neoadjuvant treatment standardized clinical tests tumor markers on tumor tissue
pain and readmission after lap ipom vs. robotic ventral hernia repair

Conditions: Hernia, Ventral

Summary: comparison of results after rtarup and lap ipom in patients with small- and medium-sized ventral hernia. retrospective cohort study of consecutive patients undergoing rtarup or ipom repair for small or medium-sized primary ventral and incisional hernias. the primary outcome was the postoperative need for transverse abdominis plane (tap) block or epidural catheter, secondary outcomes were 30-day complications, and length of stay. all patients underwent elective surgery and were followed for 30 days postoperatively.

single-center retrospective cohort study of consecutive patients undergoing rtarup or ipom repair for small or medium-sized primary ventral and incisional hernias. the primary outcome was the postoperative need for transverse abdominis plane (tap) block or epidural catheter, secondary outcomes were 30-day complications, and length of stay. all patients underwent elective surgery and were followed for 30 days postoperatively.

Eligibility criteria:
inclusion criteria: * all patients undergoing elective minimally invasive repair for small or medium-sized primary ventral or incisional hernia repairs at one academic hernia center with an unrestricted patient referral. consecutive patients undergoing ipom (december 1st, 2017 - december 1st, 2018) and rtaruprretrorectus (march 1st, 2021 - june 1st, 2021). exclusion criteria: * open repairs
hematological factors and iron status in aerobic versus anaerobic training in athletic females

Conditions: Sports Anemia

Summary: this study aimed to evaluate the hematological factors and iron status in aerobic versus anaerobic training in athletic females.

in both the short and long term, physical training causes iron status deterioration in sporty females. nonetheless, little is known about the effect of different forms of exercise (aerobic versus anaerobic) on haematological variables and iron status in sporty females during adolescence. as a result, the purpose of this study was to compare the haematological variables and iron status in aerobic versus anaerobic exercise in adolescent female athletes. another goal was to compare aerobic and anaerobic groups in terms of iron status classifications, such as normal iron status, iron deficiency with or without anaemia.

Eligibility criteria:
inclusion criteria: * healthy, virginal, nonsmoker, female athletes. * age from 16 to 19 years. * body mass index \< 25 kg/m2. * having the same socio-economic level. * following a normal balanced nutrition. exclusion criteria: * using any medical or hormonal therapy that might influence the iron status. * vegetarian athletes. * having menorrhagia or amenorrhea. * chronic inflammatory condition or existing infection. * diabetic, hypertensive or cardiac athletes. * haematological disease (with the exception of iron deficiency with or without anaemia). * having transfusion of blood.

Keywords: hematological factors iron status aerobic anaerobic athletic females adolescence
multicenter blood culture quality improvement

Conditions: Bacteremia

Summary: false positive blood culture results due to specimen contamination with bacteria inhabiting patients' skin is a common problem in emergency departments (eds) in the united states. contaminated blood cultures lead to patient harm through unnecessary hospitalizations and ed visits, delays in surgery, unneeded antibiotics, and unnecessary procedures. the investigators have developed a multifaceted quality improvement improvement bundle (the blood culture qi program) designed to minimize blood culture contamination in the ed. in this study, the investigators will implement the quality improvement bundle in six community hospital eds and evaluate its effectiveness at reducing contamination.

the blood culture qi program has four components: (1) education: content knowledge and standardized experiential training on sterile technique designed for ed nurses; (2) process redesign: change in patient safety attitude and conversion of blood culture collection from a clean to a sterile technique; (3) checklist use: reinforcement of optimal blood culture collection technique at the point of care; (4) feedback: systematic charting and reporting of contamination rates to the ed nurses who collect cultures. in order to convert blood culture collection into a fully sterile procedure, the investigators developed the sterile blood culture collection kit, a novel materials kit that contains the equipment needed to collect a culture using sterile technique, including: (1) a 3ml solution of 2% chlorhexidine gluconate - 70% isopropyl alcohol (chloraprep, carefusion) skin prep device; (2) a sterile drape; (3) a sterile needle; and (4) gauze. the investigators will evaluate the effectiveness of the blood culture qi program after implementing it in six community hospital eds. our study will compromise six replications of an interrupted time series study wherein each replication will be powered for internal validity to test the hypothesis of decreasing the contamination rate by 50% at each site. a stepped wedge (also called multiple baseline) design will be used to implement the program across hospitals to evaluate the generalizability (external validity) of program effectiveness. the primary analysis will be an interrupted time series analysis at each site comparing the proportion of ed blood cultures contaminated during a post-implementation intervention period with a pre-intervention baseline period.

Eligibility criteria:
inclusion criteria: * patients who have a blood culture ordered for clinical purposes in one of the participating centers during the study period. exclusion criteria: * age \< 18 years old

Keywords: blood culture emergency department quality improvement
nasotracheal intubation over a bougie

Conditions: Nasotracheal Intubation; Nasal Bleeding

Summary: the purpose of this study is to determine whether nasal intubation over a bougie placed via a nasal trumpet will decrease nasal trauma when compared to the conventional technique of blind nasal endotracheal tube passage.

conventional nasotracheal intubation techniques (or "conventional videolaryngoscopic techniques," cvt) are known to be associated with significant trauma to the patient's nares and the endotracheal tube itself. the investigators propose an alternative technique (nasotracheal intubation over a bougie placed via a subsequently removed nasal trumpet, or nib) which involves using seldinger technique over a bougie placed via a nasal trumpet which promises to not only be less traumatic to the patient and the endotracheal tube, but also to take less time to perform and have a higher first-attempt success rate than conventional methods. the investigators propose a randomized prospective interventional study comparing this new technique with conventional technique to see if a significant difference exists.

Eligibility criteria:
inclusion criteria: * patients scheduled for elective surgery with an anesthetic plan including asleep nasotracheal intubation exclusion criteria: * patients needing emergent airway protection * patients undergoing emergency surgery * patients whom are known to be pregnant * patients whom are currently anticoagulated (including daily aspirin use) * patients whose anesthetic includes the use of nitrous oxide * patients whom are currently incarcerated * patients 7 years of age or younger * mentally incompetent adults * patients whom refuse involvement in the study

Keywords: nasotracheal intubation
long-term safety performance of fexofenadine in asthma

Conditions: Asthma

Summary: the purpose of this study is to assess the long-term safety performance of fexofenadine compared to montelukast in subjects with asthma

the incidence of respiratory allergy in the us has increased gradually over the past several years, and current estimates suggest that allergic rhinitis and bronchial asthma affect approximately 20% and 5% of the population, respectively. rhinitis and asthma frequently coexist, and large-scale population surveys indicate that up to 38% of subjects with rhinitis have asthma, and up to 78% of subjects with asthma have chronic nasal symptoms. safety concerns with the increased use of inhaled corticosteroids, the heterogeneity of the disease, and poor compliance with asthma medication regimens, point to the need for the development of safe and convenient oral therapies for asthma. oral leukotriene receptor antagonists (eg montelukast) are the latest class of inflammation-modulating asthma drugs and appear to cause fewer long-term side effects than systemic corticosteroids and reduce the need for shorter-acting bronchodilator reliever medicines. however variability in response between patients has been observed and clinical experience with these agents is still limited. histamine is an important chemical mediator of inflammation in asthma. the benefits of antihistamine treatment in patients with mild to moderate asthma have been well documented, however their clinical use has been previously limited due to the high doses required for efficacy and their associated side effects including sedation and cognitive impairment. recent evidence indicates that in addition to h1-receptor antagonism, some of the newer nonsedating, non-impairing antihistamines appear to possess various anti-inflammatory properties at concentrations achieved at therapeutic dosages suggesting an additional benefit of these drugs in the management of allergic diseases and asthma. the purpose of this study is to assess the long-term safety performance of fexofenadine compared to montelukast in subjects with asthma.

Eligibility criteria:
inclusion criteria: * males and non-pregnant, non-breastfeeding females 12 through 80 years of age * fev1 in the context of this study is greater than 40% and not less or equal to 87% of predicted values for subjects not currently taking ics and greater than 40% and not less or equal to 95% for those subjects taking ics at visit 1 and/or visit 2 (and no albuterol use within 6 hours prior to spirometry) * improvement in fev1 of at least 12% of predicted value and at least 200ml within 15 to 30 minutes of inhaling 2 puffs of albuterol 90mcg/actuation demonstrated at study entry or documented during the previous 12 months at the study site. * use of a short-acting, beta-agonist inhaler to treat asthma symptoms on an average of at least 2 days per week during the previous 2 weeks (greater than or equal to 4 days total during the previous 2 weeks, excluding prophylactic use). exclusion criteria: * otherwise healthy
topical methotrexate with fractional co2 laser in treatment of non segmental vitiligo

Conditions: Vitiligo

Summary: this prospective, within subject clinical trial aims to evaluate the efficacy of combining fractional co2 laser with topical methotrexate versus topical methotrexate alone in treating non-segmental vitiligo. patients with comparable lesions on both sides of their body will receive both treatments randomly assigned to each side. the study assesses repigmentation, safety, patient satisfaction, and quality of life over six months.

the study is a prospective, within subject, self-controlled, randomized clinical trial conducted at the department of dermatology, assiut university. participants are patients aged 18-65 with stable non-segmental vitiligo, having comparable lesions on both sides of their body. they must not have received corticosteroid or phototherapy treatments in the last three months and must provide informed consent. exclusion criteria include other skin diseases, pregnancy, severe organ dysfunction, compromised immune function, and skin type 1 with phototherapy allergy. intervention and follow-up one side of each participant's body will receive fractional co2 laser combined with methotrexate 1% gel, while the other side will receive topical methotrexate alone, with treatments randomized to avoid bias. the laser therapy consists of four sessions at three-week intervals using specific parameters. participants will be followed up for six months, with assessments at baseline, during treatment, and post-treatment. outcome measures the primary outcome is the percentage of repigmentation, assessed through standardized digital photographs evaluated by blinded dermatologists. secondary outcomes include safety evaluation, patient satisfaction, the pattern of repigmentation, the vitiligo area scoring index (vasi) score, and quality of life measured using a validated questionnaire. methods for evaluation photographs will be taken under wood's lamp examination at baseline, before each treatment session, and two months after the final treatment. the efficacy will be evaluated by comparing pre- and post-treatment photographs. safety and patient satisfaction will be assessed throughout the study period. the study aims to provide evidence on the effectiveness of combining fractional co2 laser with topical methotrexate for vitiligo treatment.

Eligibility criteria:
inclusion criteria: * participants are patients aged 18-65 with stable non-segmental vitiligo, having comparable lesions on both sides of their body. they must not have received corticosteroid or phototherapy treatments in the last three months and must provide informed consent. exclusion criteria: * exclusion criteria include other skin diseases, pregnancy, severe organ dysfunction, compro

Keywords: fractional co2 laser vitiligo