Kornimate/medical-research-clean huggingface dataset:
chloroprocaine spinal anesthesia for cervical cerclage (cp spinal)

Conditions: Adverse Reaction to Spinal Anesthetic; Maternal Care for Cervical Incompetence

Summary: this study aims to determine whether or not spinal anesthesia with the local anesthetic drug, chloroprocaine, wears off faster than the local anesthetic drug, bupivacaine, and results in faster discharge from the post-anesthesia care unit after surgery.

this will be a prospective, randomized, double blind clinical trial. subjects will be asa i and ii women ≥18 yrs old with a singleton pregnancy in the 1st or 2nd trimester of pregnancy undergoing cervical cerclage with spinal anesthesia. patients will be randomly allocated to the chloroprocaine (cp) or bupivacaine group (bup). patients will receive spinal anesthesia with either chloroprocaine 50 mg with fentanyl 15 mcg or bupivacaine 9 mg with fentanyl 15 mcg. bupivacaine is the most common local anesthetic used for cervical cerclage with spinal anesthesia. bupivacaine is safe and has been preferred over other medications such as lidocaine, because it is associated with a low incidence of a complication from spinal anesthesia known as "transient neurologic symptoms" - a condition where pain and cramping in the buttocks and lower extremities can be experienced for several days. bupivacaine is a long-acting local anesthetic agent and therefore has the disadvantage of a prolonged anesthetic recovery that may last a few hours. chloroprocaine is a local anesthetic with a fast onset and short duration that may be used for spinal anesthesia for ambulatory procedures. chloroprocaine is currently used at the research institution for spinal anesthesia for ambulatory surgical patients, especially for lower extremity orthopedic procedures such as knee arthroscopy, as well as for pregnant patients.

Eligibility criteria:
inclusion criteria: * asa i and ii women * 18-45 yrs old * singleton pregnancy * cervical cerclage 1st or 2nd trimester of pregnancy undergoing with spinal anesthesia * height 150 - 180 cm * bmi ≤ 40 kg/m2. exclusion criteria: * any contraindication to neuraxial anesthesia (history of neurologic disease (e.g., multiple sclerosis, spinal stenosis, central or peripheral neuropathy) * pre-existing/chronic back pain * ester local anesthetic allergy, paba allergy * history of atypical cholinesterase (cp is metabolized by cholinesterase)

Keywords: chloroprocaine cervical cerclage spinal anesthesia bupivacaine
responsiveness to acute changes in exercise and relaxation (racer) trial

Conditions: Breast Cancer

Summary: the purpose of this acute study is to compare the combined effects of aerobic exercise and relaxation training on fatigue and its related cognitive components, among breast cancer survivors. participants will complete three sessions over a seven-day period in a laboratory setting.

it is hypothesized that the combination of aerobic exercise and relaxation training could have additive effects on fatigue and related cognitive outcomes. therefore, this study is designed to test the effects of exercise plus relaxation relative to aerobic exercise alone and relaxation training alone, over the course of three sessions within a seven day period. participants will complete baseline and post-testing before and after the week of training, as well as pre- and post-testing at each session. participants will be randomized to one of three conditions: 1. aerobic exercise only condition (aero) participants randomized to the aero condition will engage in three separate 20-minute sessions comprised of a 5-minute, resistance-free warm-up, and 15 minutes of moderate aerobic cycling on a stationary bike (50-70% age-predicted heart rate max). each aero session will end with a 20-minute quiet rest period. 2. relaxation only condition (relax) participants in the relax condition will complete three separate 20-minute sessions of relaxation training using a commercial neurofeedback device (headset \& smartphone app). each relax session will end with a 20-minute quiet rest period. 3. aerobic exercise and relaxation training - intervention condition (combined) participants randomized to the combined condition will complete three separate sessions comprised of 20 minutes of aero exercise followed by 20 minutes of relax training. all participants, regardless of condition will complete brief questionnaires assessing in-the-moment fatigue and affect, before and after each randomly assigned activity session. a larger survey and battery of cognitive tests will be completed at the beginning of the first appointment and at the conclusion of the third appointment.

Eligibility criteria:
inclusion criteria: * 18 years and older * previously diagnosed with breast cancer (ductal carcinoma in situ or stages i-iv) * completed at least one cycle of chemotherapy treatment within the last 5 years * must have reliable access to the internet * must report at least one complaint concerning physical function, fatigue, memory, planning, thinking, negative mood, depressive symptoms, or anxiety * must be capable of engaging in sustained stationary cycling at a moderate intensity exclusion criteria: * deaf in both ears * unable to comfortably wear a pair of ear-bud headphones * color-blind or do not have vision of at least 20/40 with the aid of contacts or glasses * history or diagnosis of epilepsy

Keywords: survivorship fatigue relax cognition exercise
positional therapy versus cpap for positional osa

Conditions: Sleep Apnea Syndromes

Summary: this is a crossover randomized controlled trial comparing a convenient positional therapy (pt) device to continuous positive airway pressure (cpap) in the treatment of positional obstructive sleep apnea (osa).

this study aims to compare a convenient positional therapy (pt) device used for 8 weeks to continuous positive airway pressure (cpap) used for 8 weeks in patients with positional obstructive sleep apnea (osa) in a crossover randomized controlled trial.

Eligibility criteria:
inclusion criteria: 1. age 21 years and above 2. epworth sleepiness scale 10 to 16 3. no cpap treatment or pt treatment for past 6 months 4. a diagnosis of positional osa based on a full in-laboratory overnight polysomnography with 1. total apnea/hypopnea index (ahi) \>10 /hour and non-supine ahi \< 10/hour 2. supine ahi greater than or equal to two times the non-supine ahi 3. at least 15 minutes of supine and non-supine sleep exclusion criteria: 1. epworth sleepiness scale ≥17 2. commercial driving 3. unable or unwilling to use both treatments (cpap and pt) 4. concurrent use of therapy for osa such as mandibular advancement splints 5. conditions that preclude the ability to lie in a non-supine position, for example a shoulder injury 6. uncontrolled severe medical/psychiatric conditions such as severe chronic heart failure, malignancy. 7. patients with pacemaker 8. skin sensitivity around the neck and/or open wound around their neck

Keywords: sleep apnea syndromes positional sleep apnea cpap night shift
effect of clopidogrel on allergen challenge in asthma

Conditions: Asthma

Summary: in asthma, breathing in an allergen, such as house dust mite induces inflammation in the airways. this process appears to involve an interaction between two different sorts of blood cells, platelets and white blood cells via a receptor called the p2y12 receptor. the purpose of this study is to determine whether the drug clopidogrel which blocks the p2y12 receptor on platelets, reduces inflammation following breathing in house dust mite in people with mild asthma.


Eligibility criteria:
inclusion criteria: * confirmed diagnosis of asthma * step one of treatment by gina (2006) guidelines * baseline fev1 \>80% predicted exclusion criteria: * current smoker * ex smoker who quit \ 10 pack years * current use of aspirin or other anticoagulant medication * diagnosis or documented history of bronchopulmonary aspergillosis or uncontrolled infections * any clinically significant cardiopulmonary abnormalities not related to pre-existing asthma * past or present tuberculosis, systemic lupus erythematosis or multiple sclerosis * any clinically significant neurological, renal, endocrine, gastrointestinal, hepatic or haematological abnormalities uncontrolled with standard treatment * history of psychiatric, medical or surgical disorders that may interfere with study * clinical history suggestive of respiratory infection in month preceding study * alcohol or recreational drug abuse * diagnosis of immunodeficiency requiring treatment * treatment with immunomodulators (inhaled corticosteroids in two months or oral corticosteroids in six months prior to study) * ongoing allergen desensitisation therapy * regular use of sedatives, hypnotics, tranquillisers * positive hepatitis viral antigens or antibodies * blood donation within 3 months of the study * live immunisation \<4 wks prior to study * inability to understand directions for study assessment * inability to be contacted in case of emergency * participation in another study at the same time or within a prior 3-month period
manage diarrhea in patients with multiple myeloma while receiving conditioning chemotherapy for autologous sct

Conditions: Multiple Myeloma

Summary: for patients who receive a hematopoietic cell transplant (hct), there is a risk of developing a diarrhea secondary to the chemotherapy which we give. diarrhea is usually harmless in healthy adults; however, in transplant patients, diarrhea can result in dehydration, negative impact on quality of life, and prolonged hospitalization. the purpose of this study was to see if colesevelam (welchol) and serum-derived bovine immunoglobulin-protein (sbi) result in a change in the frequency or consistency of your bowel movements.

this was a randomized, double-blind, placebo-controlled pilot study of sbi, colesevelam, and placebo in patients undergoing autologous hsct for the clinical care of multiple myeloma. the number of adults undergoing hematopoietic stem cell transplant (hsct) has grown significantly over the past two decades as a result of the availability of therapies for advanced hematologic and solid tumor malignancies, and the broader selection criteria for eligibility to receive these transplants. generally, the stem cell transplant procedure consists of administration of chemotherapy and/or radiation therapy to ablate all residual malignancy (called conditioning therapy), followed by intravenous infusion of hematopoietic stem cells to restore bone marrow function. generally, hsct has a positive effect on survival, despite serious adverse effects and life-threatening complications. diarrhea can affect up to 91% of patients receiving autologous or allogeneic hsct and is identified by 9% of the patients as the single most debilitating adverse effect post-hsct. other commonly encountered symptoms are nausea and vomiting (13%) and mouth sores (42%). the impact of diarrhea can be significant and result in dehydration, negative impact on quality of life, prolonged hospitalization with an increased cost and risk, and the diarrhea may be potentially life-threatening.

Eligibility criteria:
inclusion criteria: * age ≥18 years, male or female * diagnosis: multiple myeloma undergoing autologous stem cell transplantation (sct) * planning to receive conditioning chemotherapy (melphalan) for autologous stem cell transplantation and standard prophylactic antibiotics treatment. * can drink 200ml of mannitol and agrees to undergo stool, urine, and blood checks 3 times during the study. * agrees and able to take the investigational products or placebo starting from the day of completing conditioning therapy for a total of 4 weeks exclusion criteria: * patients with history of inflammatory bowel disease will be excluded from the study. * patients with prior gi tract surgical (small or large bowel) resections * the concurrent presence of systemic light chain amyloidosis * subject has known allergy or intolerance to beef or to any ingredient used in the product * women who are pregnant, breast-feeding and of child-bearing potential
magnesium supplementation for primary prevention of heart failure in obesity

Conditions: Obesity

Summary: the objective of this study is to investigate whether nutritional supplementation with magnesium can improve cardiovascular structure and function in participants with obesity - with a long-term goal of preventing clinical heart failure. specifically, in a randomized open-label pilot study, we will assess whether dietary magnesium (mg) supplementation (versus no supplementation) for 24 weeks in obese patients will improve left ventricular (lv) mass.

the investigators propose a 24-week therapeutic trial involving 40 participants with obesity from the providence va medical center without clinical heart failure. 20 participants will be treated with 400 mg of magnesium oxide twice daily, while 20 participants will receive no treatment. the trial tests the hypothesis that oral mg supplementation will improve: lv structure (by lv mass, steatosis, and ecv), lv function (systolic and diastolic), vascular health (systolic blood pressure and aortic pulse wave velocity) and visceral adiposity.

Eligibility criteria:
inclusion criteria: body mass index greater than 30 kg/m2 exclusion criteria: 1. history of hospitalization for heart failure (systolic or diastolic); 2. unstable angina or prior myocardial infarction; 3. lv ejection fraction \<50% on imaging study; 4. valvular heart disease (stenosis or insufficiency) greater than moderate degree; 5. renal dysfunction, serum creatinine \>2.5 mg/dl or estimated creatinine clearance \<30 ml/min/1.73 m2 (30), 6. pregnant women or actively breastfeeding women 7. history of drug supplementation within the last 6 months in which more than 50 miliequivalents per day of supplemental magnesium is contained
application of direct current transcranial stimulation, remotely supervised in chronic fatigue

Conditions: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Summary: it is a one-arm open-label interventional study with transcranial direct current stimulation in an remote home-based setting with the aims to evaluate the feasibility (usability of the device, compliance of patients, usability of the teletherapy), the effectiveness (clinical ratings) and the compatability of this intervention in 20 patients with myalgic encephalomyelitis/chronic fatigue syndrome.


Eligibility criteria:
inclusion criteria: * me/cfs diagnosis according to the canadian consensus criteria * residence near regensburg and mother language german * written informed consent * stable medication if possible exclusion criteria: * contraindications for transcranial direct current stimulation * certain neurological conditions as assessed by study physician * participation in another study * pregnancy and lactation period

Keywords: transcranial direct current stimulation
accurate, rapid and inexpensive mri protocol for breast cancer screening

Conditions: Breast Cancer

Summary: the purpose of this study is to test an innovative mri breast cancer screening method in women with mammographically dense breasts as well as other women with moderately increased cancer risk. mri, combined with other methods of risk assessment, has potential to significantly improve sensitivity to cancer in dense breasts and detect cancer in all cases at a much earlier stage, with far fewer interval cancers than mammography. previous tests of mri sensitivity show that this screening could significantly increase the likelihood of detecting invasive cancers resulting in decreased mortality from breast cancer. suspicious lesions will be defined by the clinical interpretation of the breast mri images performed by the attending breast radiologists. based on the radiologist determination that the mri findings are suspicious (these findings include masses, non-mass enhancement and foci), suspicious lesions will be assigned a bi-rads code specifying whether additional work up or biopsy is necessary. these are bi-rads codes 0, 4 and 5. false positive diagnosis should be minimized as all attending physicians reading breast mri at this institution are fellowship trained in breast imaging.


Eligibility criteria:
inclusion criteria: * women that have had a mammographically and/or sonographically identified finding that will require image guided biopsy * women between ages 40-74 with dense breasts having a mammogram * women identified as having an average or intermediate risk of breast cancer (defined as 10- 20% lifetime risk based on a clinical risk model). exclusion criteria: * women with metallic implants * women that are claustrophobic * women that have a fear of needles or contrast * women that have had an allergic reaction to contrast in the past * women that are pregnant * women who are demonstrated to be at risk for an allergic reaction or nephrogenic systemic fibrosis (nsf)

Keywords: mri screening breast cancer
sequential transplantation of ucbscs and islet cells in children and adolescents with monogenic immunodeficiency t1dm

Conditions: Diabetes Mellitus, Type 1; Immunologic Deficiency Syndromes

Summary: this study evaluates the efficacy of sequential transplantation of umbilical cord blood stem cells and islet cells in children with monogenic immunodeficiency type 1 diabetes mellitus. umbilical cord blood stem cell transplantation will be performed first. children with stable immune reconstruction will than receive islet cell transplantation.

monogenic immunodeficiency type 1 diabetes mellitus (t1dm) usually onsets in early age and has a long course of treatment. because of t cell deficiency, patients are prone to recurrent infection, hemorrhage, sepsis, colitis or complications of diabetes mellitus, which lead to early death. new clinical treatment schemes have been explored and introduced around the world. sequential transplantation of umbilical cord blood stem cells and islet cells is the latest treatment method for these children. early treatment of monogenic immunodeficiency t1dm children can avoid disease-related organ toxicity, infection risk associated with chronic immunosuppression, and possible prevention of autoimmune endocrine organ damage. thus, sequential transplantation of umbilical cord blood stem cells and islet cells is the only possible cure for those patients currently.

Eligibility criteria:
inclusion criteria: 1.type 1 diabetes mellitus children with genetic immunodeficiency 1. meet the diagnostic criteria of type 1 diabetes mellitus: clinical manifestations of typical diabetes mellitus include polyphagia, polyuria, weight loss, or diabetic ketoacidosis, confirmed by blood sugar level, islet function and autoimmune antibody. 2. existence of extrapancreatic organ damage: (1) inflammatory bowel disease, (2) impairment of renal function, (3) repeated infection of mouth, skin, anus or whole body, (4) immune hepatitis, (5) persistent chronic immune iridocyclitis, (6) immune adrenalinitis leading to adrenocortical dysfunction, (7) pituitary inflammation leading to hypophysis, (8) rheumatoid disease, (9) immune vasculitis, (10) systemic lupus erythematosus, (11) other organs besides thyroid function damage. suffering from one or more of above diseases. recurrence after receiving regular clinical treatment, including symptomatic treatment of organ protective drugs. 3. gene mutation was found according to gene diagnosis: gene mutation was found by gene sequencing. literature searches at home and abroad confirmed that the defect of the gene resulted in autoimmune or immune dysfunction, resulting in multiple organ dysfunction and poor prognosis. exclusion criteria: 1. mature and effective treatment methods are available. 2. hiv, hbv and hcv were positive. 3. a the active period of infection. 4. at the active stage of malignant tumors. 5. combination of other fatal diseases. 6. existence of mental and psychological diseases.

Keywords: islets of langerhans transplantation cord blood stem cell transplantation
impact of nurse-led intervention on asthma control in children

Conditions: Asthma in Children

Summary: this randomized control trial design (rct) study was conducted on children aged 6 -11 years

this randomized control trial design study was conducted on children aged 6 -11 years, visiting the pediatric outpatient department and emergency at dr. ruth pfau civil hospital karachi. for the experimental group, a nursing educational intervention session was conducted with the patient and family/caregiver by the principal investigator, and a doctor provided the usual care/treatment. in contrast, the control group received only the usual care/treatment provided by the doctor. for the control group, educational material on asthma was provided in a booklet according to global initiative of asthma (gina) guidelines. pre childhood-asthma control test (c-act) score of participants was measured before the intervention, and post-c-act score measurement was made after one month using the same questionnaires and c-act tool.

Eligibility criteria:
inclusion criteria: * children between the aged 6 to 11 years * have asthma diagnosed by a physician at least 6-month back * uncontrolled asthma based on c-act score 19 or less 19. exclusion criteria: * chronic respiratory illnesses like t.b. cystitis and fibrosis. * sinusitis, * gastrointestinal reflux disease, * rhinitis
aggressive squamous cell carcinoma in organ transplant recipients

Conditions: Squamous Cell Carcinoma

Summary: to identify risk factors for aggressiveness in squamous cell carcinoma of the skin in organ transplant recipients.

squamous cell carcinomas (scc) are one of the most common skin cancers. they belong to the epithelial neoplasm of the skin, which manifest a local aggressive growth and have potential for metastasis. organ transplant recipients have a hundredfold higher incidence of scc. unfortunately the primary tumor, regional nodes, metastasis (tnm)-classification for the prognosis of scc in this group of patient has not yet been established. therefore there are no standardised criteria for evaluation of local recurrence or prognosis. the aim of this study is to identify criteria, which permit a risk assessment relating to aggressiveness of scc.

Eligibility criteria:
inclusion criteria: organ transplant recipients with: * \> 9 scc in total or * \> 2 scc per year (in any one year) or * any single "index" scc that has a very poorly differentiated cell morphology or that behaved aggressively in terms of local recurrence or local/systemic metastasis exclusion criteria: * non organ transplant recipients

Keywords: squamous cell carcinoma