Kornimate/medical-research-clean huggingface dataset:
impact of forced expiration on pleural drainage duration (kpdp)

Conditions: Pulmonary Malformations; Child

Summary: following thoracic surgery, pleural effusion in pleural cavity requires post-operative drainage. pleural effusion is responsible for pulmonary congestion, atelectasis, hypoventilation, lower efficacy of diaphragmatic curse, lower pulmonary reexpansion and vicious attitude. these complications could be avoided by respiratory physiotherapy. forced expiration technic in ipsilateral decubitus is one of these technics but has never been proved better than other technics regarding its efficiency. the aim of the study is to compare the impact of such a technic on post operative thoracic drainage after pulmonary, pleural or mediastinal pediatric surgery.

following thoracic surgery, pleural effusion in pleural cavity requires post-operative drainage, most often for few days (2 to 5 days) until fluid quantity is lower than 50 ml / 24h. pleural effusion may cause pulmonary congestion, atelectasis, hypoventilation, lower efficacy of diaphragmatic curse, lower pulmonary reexpansion and vicious attitude. respiratory physiotherapy in such situations has different aims : pulmonary decongestion and reexpansion, aid for drainage and pleural fluid reduction, avoiding complications and preventing vicious attitudes. these aims are learned in physiotherapy formation institutes. the forced expiration technic in ipsilateral decubitus is justified by pleural physiology and is used after pediatric surgery without any scientific evidence regarding his efficacy using pulmonary physiotherapy after pulmonary, mediastinal or pleural surgery for children is not systematic and depends on prescriber without any professional recommendation. actually no scientific evidence regarding technical or postural indicates improvement of effusion drainage. it seems to be necessary to validate efficiency of such a technic and evaluate its consequences on post-operative pain. furthermore, this pleural drainage impacts directly the duration of hospitalization and paramedical workload

Eligibility criteria:
inclusion criteria: * children 0-4 years * in front have a mediastinum or lung surgery (lung segmentectomy or lobectomy or non anatomical lung resection) with pleural drainage, regardless of the type drain * whose parents or the holder of parental authority have signed a consent * whose parents or the holder of parental authority are affiliated to a social security scheme exclusion criteria: * chest trauma * oncology (chest tumors, lung metastases) * drained pleuropneumopathies * spine surgery * heart surgery * surgery for pectus excavatum * route of anterior surgical approach sternotomy chest kind * patients intubated and / or ventilated * patients with preoperative sepsis

Keywords: chest physiotherapy post operative period forced expiration pleural drainage duration
a study to evaluate safety and efficacy of ocrelizumab in comparison with fingolimod in children and adolescents with relapsing-remitting multiple sclerosis (rrms)

Conditions: Relapsing-Remitting Multiple Sclerosis

Summary: this double-blind, double-dummy study will evaluate the safety and efficacy of ocrelizumab compared with fingolimod in children and adolescents with rrms aged between 10 and \< 18 years over a flexible duration. the double-blind period will last until after the last participant randomized has completed 24 weeks.

this phase iii randomized, double-blind, double-dummy, multicenter study will evaluate the safety and efficacy of ocrelizumab administered by iv infusion every 24 weeks compared with fingolimod taken orally daily, in children and adolescents with rrms aged between 10 and \< 18 years. the study plans to enroll 171 participants in a 1:1 randomization (ocrelizumab:fingolimod), globally. this study consists of a double-blind, double dummy period in which participants will be treated with either active ocrelizumab or active fingolimod for a flexible duration. participants who complete the double-blind period will be offered the possibility to enter an optional open-label extension (ole) treatment period of at least 144 weeks with ocrelizumab.

Eligibility criteria:
inclusion criteria: * body weight ≥ 25 kilograms (kg) * diagnosis of rrms in accordance with the international pediatric multiple sclerosis study group (ipmssg) criteria for pediatric multiple sclerosis (ms), version 2012, or mcdonald criteria 2017 * expanded disability status scale (edss) at screening: 0-5.5, inclusive * for all countries except germany, at least one ms relapse during the previous year or two ms relapses in the previous 2 years or evidence of at least one gd enhancing lesion on mri within 6 months inclusion criteria for optional ole period: -participants in group a (ocrelizumab in the double-blind period \[dbp\]) and group b (fingolimod in the dbp) who, in the opinion of the investigator, may benefit from switching to ocrelizumab and who have completed the dbp with study treatment (ocrelizumab/fingolimod), may participate in the ole period exclusion criteria: * known presence or suspicion of other neurologic disorders that may mimic ms * significant uncontrolled somatic diseases, known active infection or any other significant condition that may preclude participant from participating in the study * participants with severe cardiac disease or significant findings on the screening electrocardiograph (ecg) exclusion criteria for optional ole period: -participants who have discontinued the study during the dbp

Keywords: pediatric multiple sclerosis pediatric ms children ms children multiple sclerosis pediatric ocrelizumab
wound irrigation with saline versus hypodilute-chlorhexidine after cesarean section (wishes study)

Conditions: Cesarean Section Complications; Cesarean Section; Infection

Summary: this investigator-initiated, open-label, randomized controlled trial will explore the effects of two treatment arms, comparing standard treatment with normal saline against irrisept, a jet lavage solution containing a low concentration of chlorhexidine gluconate (chg) at 0.05% in 99.95% sterile water for irrigation. the study aims to evaluate the impact on postoperative wound healing in patients who have undergone cesarean delivery.


Eligibility criteria:
inclusion criteria: * age 18 or older * singleton pregnancy * planned cesarean delivery at gestational age 37 weeks or later at loma linda university children's hospital * planned post-operative follow up with loma linda obgyn * speak english or spanish * at least one of the following medical complications: obesity bmi\>= 30kg/m2, diabetes, spontaneous rupture of membranes, intraamniotic infection exclusion criteria: * emergency cesarean delivery
calcitriol in treating patients with a rising psa level following treatment for prostate cancer

Conditions: Prostate Cancer

Summary: rationale: calcitriol, a form of vitamin d, may be able to prevent or slow the growth of prostate cancer cells. purpose: phase ii trial to study the effectiveness of calcitriol in treating patients who have a rising psa level following previous treatment for prostate cancer.

objectives: i. determine the response to pulse calcitriol in patients with previously treated adenocarcinoma of the prostate with rising psa levels. ii. assess the impact of this regimen on the slope of the psa rise in these patients. iii. determine the qualitative and quantitative toxic effects of this regimen in these patients. iv. assess the impact of this regimen on the quality of life of these patients. outline: all patients remain on a reduced calcium diet for the duration of the study. twelve hours prior to treatment, patients begin drinking 4-6 glasses of extra fluid for 3 days. patients receive oral calcitriol over 4 hours weekly. treatment continues in the absence of disease progression or unacceptable toxicity. quality of life is assessed at baseline, every 4 weeks during treatment, and at the end of the study. patients are followed for at least 1 month. projected accrual: a total of 15-25 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: histologically or cytologically proven adenocarcinoma of the prostate previously treated with prostatectomy or definitive radiotherapy rising psa after post definitive therapy nadir on at least 3 measurements at least 2 weeks apart psa at least 0.4 ng/ml for prostatectomy patients psa at least 1.0 ng/ml for radiotherapy patients patient characteristics: age: 18 and over performance status: ecog 0-2 life expectancy: greater than 2 months hematopoietic: not specified hepatic: not specified renal: phosphate no greater than 4.2 mg/dl creatinine no greater than 1.3 mg/dl calcium no greater than 10.5 mg/dl no history of hypercalcemia cardiovascular: no significant heart disease no myocardial infarction within past 3 months no history of heart failure cardiac ejection fraction at least 30% other: no other significant active medical illness that would preclude compliance fertile patients must use effective contraception prior concurrent therapy: biologic therapy: not specified chemotherapy: no prior systemic chemotherapy for metastatic prostate cancer (except neoadjuvant treatment for localized prostate cancer) endocrine therapy: no prior systemic hormonal therapy for prostate cancer (except neoadjuvant treatment for localized prostate cancer) radiotherapy: see disease characteristics surgery: see disease characteristics other: no other concurrent systemic therapy for metastatic prostate cancer at least 30 days since other prior investigational drugs no concurrent digoxin at least 7 days since prior thiazide diuretic therapy no concurrent magnesium containing antacids, bile resin binding drugs, or calcium supplements

Keywords: adenocarcinoma of the prostate recurrent prostate cancer
neuroprotection bundles comatose survivors for in cardiac arrest trial

Conditions: Cardiac Arrest; Post-cardiac Arrest Care

Summary: the investigators designed laptops to determine the effectiveness of a goal-directed neuroprotection bundles of active management including body temperature,paco2,pao2,position,blood glucose ,blood sodium,blood pressure and lactate vs. usual care in adult post-cardiac arrest care. laptops is a large-scale pragmatic clinical trial to provide reliable evidence over the effectiveness of a widely applicable goal-directed care bundle in acute phase of adult post-cardiac arrest care.


Eligibility criteria:
inclusion criteria: * age ≥ 18 years and \< 80 years * patients of in-hospital or out-of-hospital cardiac arrest who have returned -spontaneous circulation (rosc) after cardiopulmonary resuscitation and do not require cpr for more than 20 minutes; * patients who are unconscious after rosc, defined as four motor response score \< 4 points or gsc ≤ 8 points; * family members or legal representatives signed informed consent. exclusion criteria: * unwitnessed cardiac arrest, estimated time from cardiac arrest to start of cpr \> 30 minutes; * time from cardiac arrest to rosc \> 60 minutes; * patients who woke up immediately after rosc by cpr; * end-stage diseases; * cardiac arrest considered to be caused by neurological diseases; * the patient was in a vegetative state before cardiac arrest; * the interval from the onset of cardiac arrest to enrollment is \>72 hours .

Keywords: post-cardiac arrest care neuroprotection cardiac arrest care bundle clinical trial stepped-wedge cluster
rehabilitation of children with multiple disabilities

Conditions: Cerebral Palsy; Autism; Down's Syndrome; Brain Injury

Summary: the objective of the study is to compare the usual care and treatment of children and youth (0-19 years) with multiple developmental delays and disabilities and their families in simcoe york with a co-ordinated, navigated approach to care using the children's treatment network (ctn) services.

the children's treatment network (ctn)links existing children's services rather than creating a new centre. the purpose of the evaluation is to compare the effectiveness and efficiency of this service with the usual care that people receive. 500 children will be randomized to receive either usual care (250) or the co-ordinated, navigated care from ctn (250). the primary question to be addressed is whether the more integrated ctn model of service improves family-centered services, parent mental health, parenting, family function and the quality of the child's life and the families resource needs as well as reduce expenditures for the families' use of all other health and social services compared to the outcomes of usual care alone. what children and families with what characteristics and circumstances most benefit from which approach to the treatment of childhood disability in simcoe-york? at what cost? agencies providing services to children will be evaluated as to how effective their integration of teams are functioning, their partnership with each other and capacity building in the community.

Eligibility criteria:
inclusion criteria: * children and youth up to 19 years of age * living in simcoe-york. * english speaking * multi-need family * children on agency service wait lists * children under the care of children's aid societies * families with more than 1 disabled child exclusion criteria: -youth over 19 years.

Keywords: children rehabilitation family functioning mental health costs integration
the effects of mbsr on patients with tbi and chronic insomnia

Conditions: Chronic Insomnia; TBI (Traumatic Brain Injury)

Summary: to evaluate the effects of mindfulness based stress reduction (mbsr) as an adjunct to usual clinical care for treatment of stress and chronic insomnia for patients with mild to moderate traumatic brain injury (mtbi). mbsr is a standardized protocol of meditation and yoga that has been studied extensively in other populations, however the effects of mbsr have not yet been well studied in the proposed population of service members with a traumatic brain injury (tbi) who are experiencing insomnia.

randomized, controlled trial with 1:1 randomization (n=50). the control group will receive the usual care for tbi through the clinical program with standard providers based on usual patient evaluation and needs. the intervention group will receive mbsr in addition to the usual care through the tbi program. the usual care pathway will include physician visits, rehabilitation therapies (pt/ot/st/et al), and other providers as needed based on recommendations by his or her providers. some variability will exist, but withholding standard of care would be unethical and standardizing care would be impossible. however, providers will be asked that medications, et al that could affect sleep remain unchanged during the trial period (maximum 12 weeks), which is reasonable given that patients have a chronic injury and no emergent/acute needs based on inclusion/exclusion criteria. subjects in a control group will be offered complimentary mbsr after 6 month follow up visit is completed.

Eligibility criteria:
inclusion criteria: 1. patients with mild-to-moderate tbi (as defined by the dod criteria) 2. right-handedness 3. insomnia severity index ≥15 4. deers eligible at the time of enrollment 5. not pregnant 6. male and female subjects 18 to 60 years old 7. insomnia disorder per dsm-v criteria exclusion criteria: 1. inability to speak or understand english (because this is a group intervention, it requires a common language) 2. patients who require assistance with activities of daily living (adls) 3. active practice of meditation and/or yoga or participation in meditation/yoga classes in the last 6 months prior to enrollment 4. signs or symptoms of upper motor neuron syndrome, any major systemic illness or unstable condition which could interfere with protocol compliance 5. active psychiatric disease that would interfere with participation in the trial, psychotic features, agitation, or behavioral problems within the last 3 months that could interfere with protocol compliance 6. a history of alcohol/substance abuse or dependence within the past 6 months 7. any neurosurgical intervention affecting brain parenchyma 8. unstable seizure activity 9. concurrent participation in another clinical research trial with investigational drug or previous participation with the last investigational drug administered less than 4 weeks prior to screening 10. females who are pregnant or planning to become pregnant in 6 months following screening.

Keywords: mbsr, tbi, insomnia
efficacy of transcatheter radiofrequency ablation of atrial flutter with standard irrigated catheter with flexible tip

Conditions: Atrial Flutter

Summary: the purpose of this study is to evaluate the efficacy of transcatheter ablation of atrial flutter with a standard irrigated catheter with flexible tip, as evaluated by percentual success of the procedure.

no more available data

Eligibility criteria:
inclusion criteria: * both sexes; age\>18 yrs * ecg documentation of at least 2 episodes of common atrial flutter or evidence of ongoing atrial flutter. * no contraindications to transcatheter radiofrequency ablation by a standard 4mm irrigated flexible tip catheter * patients willing to accept the tests and to follow standard procedures * patients who understand the nature of the procedure and who are willing to participate and to sign the informed consent before enrollment exclusion criteria: * atrial fibrillation * any arrhythmia requiring antiarrhythmics in the 6 months post procedure * intra atrial thrombosis * nyha class iv * unstable angina or acute myocardial infarction (ami) in the last 3 month * untreated wolf parkinson white syndrome * contraindications to oral anticoagulation * life expectancy \< 12 month * major surgery or interventional procedure already planned in the 6 month following ablation * pregnancy or breast-feeding * participation in another study

Keywords: atrial flutter
effect of dapagliflozin on the recurrence of atrial tachyarrhythmia in patients undergoing catheter ablation of atrial fibrillation

Conditions: Atrial Fibrillation Recurrent; Catheter Ablation

Summary: the goal of this clinical trial is to test the effect of dapagliflozin on the recurrence of atrial tachyarrhythmia in patients undergoing catheter ablation of atrial fibrillation. the main questions it aims to answer are: • if dapagliflozin will reduce the recurrence of all atrial tachyarrhythmias \[atrial fibrillation (af), atrial flutter (afl) and atrial tachycardia (at)\] greater than 30 seconds during one-year follow-up after catheter ablation. participants will receive dapagliflozin (forxiga) 10 milligram (mg) once a day (qd) for 3 months after catheter ablation of atrial fibrillation. researchers will compare patients who receive usual care to see if dapagliflozin will reduce the recurrence of all atrial tachyarrhythmias (af/afl/at) during one-year follow-up after catheter ablation.

this trial is the third phase of random allocation and non-blind trial. it is divided into study group and control group. the study group is dapagliflozin therapy, and the treatment period is three months post catheter ablation. the control group is usual care (without dapagliflozin). the follow-up observation period will be one year after catheter ablation. this trial was performed at kaohsiung chang gung memorial hospital and chang gung memorial hospital, linkou, and chiayi branches, and it is a multi-center trial. the study flow chart is as follows.

Eligibility criteria:
inclusion criteria: * ability to give written informed consent * men and women age \>= 20 years. * paroxysmal, persistent or long-standing persistent atrial fibrillation * egfr \>= 25 ml/min/1.73 m2 exclusion criteria: * receiving therapy with a sodium-glucose cotransporter 2 (sglt2) inhibitor prior to randomization, or intolerance to an sglt2 inhibitor. * type 1 diabetes mellitus * acute coronary syndrome, coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting), ablation of atrial flutter/fibrillation, ischemic stroke, and transient ischemic attack within 12 weeks prior to randomization * active malignancy * women of child-bearing potential who have a positive pregnancy test at randomization or who are breast-feeding * a life expectancy of fewer than 2 years due to any non-cardiovascular condition, based on the investigator's clinical judgment * expected surgery for structural heart disease, and secondary atrial fibrillation (due to cardiac surgery, infection, or hyperthyroidism)
clinical and microbiological effects of a mouthwash containing chlorine dioxide

Conditions: Halitosis

Summary: previous research has shown the oxidizing properties and microbiological efficacies of chlorine dioxide (clo2). however, no clinical studies have investigated its microbiological efficacies on periodontal and malodorous bacteria. the aim of this study was to assess the inhibitory effects of a mouthwash containing clo2 on morning oral malodor and on salivary periodontal and malodorous bacteria using for 7 days.

background: previous research has shown the oxidizing properties and microbiological efficacies of chlorine dioxide (clo2). its clinical efficacies on oral malodor have been evaluated and reported, however, no clinical studies have investigated its microbiological efficacies on periodontal and malodorous bacteria. the aim of this study was to assess the inhibitory effects of a mouthwash containing clo2 on morning oral malodor and on salivary periodontal and malodorous bacteria using for 7 days. methods: a randomized, double blind, crossover, placebo-controlled clinical trial was conducted among 15 healthy male volunteers, who were divided into 2 groups. in the first test phase, the group 1 subjects (n = 8) were instructed to rinse with the experimental mouthwash containing clo2 twice per day for 7 days, and those in group 2 (n = 7) to rinse with the control (placebo) mouthwash without clo2. in the second test, phase after a one week washout period, each group had used the opposite mouthwash for 7 days. at baseline and after 7 days, oral malodor was evaluated with om, and concentrations of hydrogen sulfide (h2s), methyl mercaptan (ch3sh) and dimethyl sulfide ((ch3)2s), the main vscs of human oral malodor, were evaluated with gc. clinical outcome variables included plaque and gingival indices, and the winkel tongue coating index(wtci). the samples of saliva were microbiologically investigated. outcome variables were compared by t-test and mann-whitney test.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of oral malodor exclusion criteria: * oral malodor caused by foods

Keywords: chlorine dioxide mouthwash halitosis bacteria saliva
comparison of a compound with pilocarpine and brimonidine to improve near vision in healthy presbyopic patients

Conditions: Presbyopia

Summary: safety and efficacy of pilocarpine, brimonidine, oxymetazoline, hyaluronic acid, bromfenac (pbohb) ophthalmic compound compared to pilocarpine and brimonidine to improve uncorrected near vision in healthy presbyopic patients one hour after instillation.

to determine the safety and efficacy of a novel pharmacological compound of pilocarpine, brimonidine, oxymetazoline, hyaluronic acid, bromfenac (pbohb) to improve uncorrected near vision in healthy presbyopic patients compared to pilocarpine and brimonidine one hour after binocular instillation.

Eligibility criteria:
inclusion criteria: * healthy * presbyopic * 40 - 59 years exclusion criteria: * diabetics * previous eye surgery * previous eye disease * \> 0.50 myopia * \> 1.5 hyperopia or astigmatism