Kornimate/medical-research-clean huggingface dataset:
the erector spinae plane block and its effect on respiratory status and pain management in rib fracture patients

Conditions: Rib Fractures

Summary: the purpose of this research study is to identify the benefits of a type of nerve block, called an erector spinae plane block (esp), in the treatment of patients with multiple rib fractures and uncontrolled pain despite receiving current institutional standards of care.

rib fractures are one of the most common injuries secondary to blunt chest trauma, and carry significant risk in terms of patient morbidity and mortality. pulmonary complications resulting from these injuries include severe atelectasis with hypoxemia, pneumonia, pleural effusions, respiratory distress syndrome, need for mechanical ventilation and icu admission, and prolonged hospital stay. many institutions have tried to develop protocols to risk stratify and appropriately treat these patients, with the goal of predicting those with higher likelihood of pulmonary complications in order to minimize additional morbidity. studies have demonstrated critical spirometry values which correlate to worse patient outcomes; specifically, vital capacity less than 50% predicted, or less than 2l. subsequently, there have been numerous attempts to identify the best treatment interventions for these high risk patients. in addition to multi-modal pain management, the most commonly used procedures include thoracic epidurals, continuous or single shot paravertebral blocks, and intercostal blocks. however, all of the above interventions carry significant risk, and the frequent use lovenox thromboprophylaxis drastically limit their use. recently, a novel peripheral nerve block technique has been developed, an erector spinae plane block (esp), which may provide similar or greater efficacy to the above, with significantly less risk to the patient.

Eligibility criteria:
inclusion criteria: * blunt chest trauma * sustaining at least 3 unliateral rib fractures * resultant vital capacity less than 30% predicted * pain score reaches threshold despite using the current institutional standard of care for pain control exclusion criteria: * patients whose weight less than 60kg. * patients with bilateral rib fractures. * patients that are intubated and mechanically ventilated. * pregnant individuals. * any individual with a documented allergy to ropivacaine. * patients with limited english proficiency (lep) * patients whose body habitus prevents the practitioner's ability to adequately perform the procedure.
study of knowledge translation of clinical practice guidelines for ventilator associated pneumonia

Conditions: Ventilator Associated Pneumonia

Summary: the purpose of this prospective, multicentre, time-series study is to develop, implement, refine, and evaluate a sustainable behaviour change strategy in the intensive care unit (icu).

background: in order to improve the care of our patients, it is necessary for research evidence to be translated into clinical practice. there are gaps in our understanding of knowledge translation (kt) and this is evident in the intensive care unit (icu), specifically as it applies to the prevention, diagnosis and treatment of ventilator-associated pneumonia (vap). vap is associated with a high burden of illness in the critically ill and there is an extensive amount of research evidence on this disease. it has been demonstrated that best practice as defined by research evidence is not uniformly applied to vap. in addition, recent advances in vap knowledge need be disseminated and implemented in order to improve patient safety and outcomes from vap. a systematic process of knowledge transfer is crucial to translate this research into evidence-based bedside practice and the development and implementation of evidence based clinical practice guidelines (cpgs) may facilitate vap knowledge uptake. in addition, there is a need to study knowledge translation (kt) in the icu since there is little information about optimal kt and cpg implementation strategies in this environment and efforts that are effective in other clinical areas may not result in meaningful change in the icu. research question: what is the effect of vap cpgs implemented by a multidisciplinary behaviour change strategy (consisting of multifaceted educational strategies led by local opinion leaders and augmented with reminders) on vap guideline concordance and on clinical vap outcomes in the icu? research plan: data will only be collected on consecutive patients mechanically ventilated for at least 48 hours. the following health care professionals will be studied to assess the behaviour change strategy for the vap cpgs: physicians (intensivists, icu fellows, icu rotating residents), nurses, respiratory therapists, dieticians, physiotherapists and icu administrators. the study will be conducted in 3 phases: 1. development of a behaviour change strategy consisting of three components: * local opinion leader team * educational strategy * reminder system 2. prospective implementation of the behaviour change strategy over a 24 month period 3. prospective evaluation of the behaviour change strategy over a 24 month period * concordance with vap guidelines over time * factors associated with vap guideline concordance * clinical vap outcomes pre- and post-guideline implementation

Eligibility criteria:
inclusion criteria: * age \>= 17 years old * mechanically ventilated \> 48 hours \< 96 hours exclusion criteria: * previous enrollment in the study

Keywords: ventilator associated pneumonia knowledge translation clinical practice guidelines education behaviour change
an observational study on postoperative symptoms after thyroidectomy (pos-t)

Conditions: Thyroid Cancer

Summary: this observational study aimed to evaluate the safety and efficacy of postoperative management in patients with thyroid cancer who received subtotal or total thyroidectomy.

1. characteristic analysis of improvement in quality of life and symptoms after surgery in cancer patients 2. multifaceted symptom evaluation of cancer patients visiting medical institutions 3. evaluation of effectiveness and safety of treatment for postoperative symptoms in thyroid cancer patients 4. analysis of the effectiveness and prognosis of cancer-related treatment for each patient with cancer 5. analysis of prognostic factors for disease-free survival and overall survival of cancer patients among adult men and women aged 19 years or older who have been diagnosed with thyroid cancer, who have undergone partial or total thyroidectomy and visited the hospital for postoperative management, the characteristics of the visiting patient, quality of life, characteristics of cancer-related symptoms, and treatment effectiveness, we intend to conduct a prospective observational study to evaluate safety and its relationship with prognosis. in addition, we aim to form the basis for follow-up research through the establishment of an oriental medicine cancer cohort and database.

Eligibility criteria:
inclusion criteria: * 19 years of age or older * those who have been confirmed to have a malignant tumor of the thyroid gland by biopsy or imaging * subjects who have undergone partial thyroidectomy or total resection within 1 month * those who have agreed to the implementation of chinese medicine treatment * the eastern cooperative oncology group(ecog) performance status 0-3 * those who understand the content of the study and agree to participate in the study exclusion criteria: * ○ when it is judged that other diseases other than cancer (dementia, cerebrovascular disease, severe organ failure, etc.) may have a significant effect on the decline of physical function * when it is judged that the life expectancy is less than 3 months and sufficient follow-up cannot be carried out * when emergency or major surgery or surgical intervention is required that takes precedence over postoperative treatment * pregnant and lactating women * other researchers who are judged to be unsuitable for research
comoral® the oral irrigation unit clinical trial

Conditions: Gingivitis; Plaque

Summary: this is a clinical study to evaluate the safety and effectiveness of comoral®, the intraoral water-spraying cleaning device that is developed to remove plaque around teeth in the oral cavity. to do so, 42 healthy subjects, 21 control and 21 experimental, will be recruited. to establish the baseline, all subjects will receive dental hygiene service. after 2 weeks, patients will be randomly assigned to either control or intervention group (21 individuals each). both groups will be asked to brush their teeth once a day but without dental floss, mouth rinse, and gum chewing, throughout the 4 weeks of study period. during the study period, the experimental group will receive comoral® treatment three times a day every day for 4 weeks except saturday and sunday. subjects will get evaluated for the oral status(pi, bop, gi, pd, gr, cal) and the status of periopathogens on visit 1, visit 2 and visit 3.

this is a randomized, open-labeled, single-centered clinical study to evaluate comoral® the intraoral water-spraying cleaning device that is developed to remove plaque around teeth in the oral cavity. the purpose of this clinical study is to evaluate the safety and effectiveness of comoral® the oral irrigation unit in preventing gingivitis and plaque formation in adult patients. 42 patients between 18 to 25 years old who have a periodontal probing depth of 3 mm or less will be recruited. to establish the baseline, all the patients will receive dental hygiene service. after 2 weeks (visit 1), patients will be randomly assigned to either control or intervention group (21 individuals each). they will be asked to do the following instruction; control group (21 total) - the individuals in the control group will be asked to brush their teeth once a day at home throughout the 4 weeks of study period. they will be asked not to use the supplementary oral hygiene products including mouth rinse, dental floss and chewing gum. experimental/intervention group (21 total) - the individuals in this group will be asked to brush their teeth once a day at home throughout the 4 weeks of study period. they will be asked not to use the supplementary oral hygiene products including mouth rinse, dental floss and chewing gum. instead, they will be asked to come to the clinic to use comoral® three times a day, every day except saturday and sunday. subjects in both groups will be evaluated for clinical indices (pi, bop, gi, pd, gr, cal) and the status of periopathogens on visit 1(baseline, visit 2(after 2 weeks), and visit 3(after 4 weeks). to measure the status of periopathogens, 3ml of saliva will be collected from each subject.

Eligibility criteria:
inclusion criteria: * healthy adult patients (asa 1-2) aged 18 to 25 with a probing depth of 3mm or less * those with 3 or more natural teeth in each quartile * those who can voluntarily sign the consent form exclusion criteria: * existing dental caries * existing periodontitis * other oral diseases

Keywords: comoral the oral irrigation unit
upar-pet/mri in patients with prostate cancer for evaluation of tumor aggressiveness

Conditions: Prostate Cancer

Summary: prospective study to evaluate the value of upar-targeted pet/mr scan using the tracer 68ga-nota-ae105 in patients with newly diagnosed prostate cancer

prostate cancer is one of the most frequent types of cancer in men. the characteristics of the disease varies significantly among patients where some have an indolent type of cancer, from which they will never experience symptoms while others have highly aggressive malignant disease that requires prompt therapeutic action. treatment of localized prostate cancer is based on a risk stratification, where patients are either offered therapy with curative intent - surgery or radiotherapy - or in case of low-risk disease an "active surveillance" strategy can be advised. in active surveillance the disease is monitored by psa measurement, repeated biopsies and digital rectal examination. some patients progress during active surveillance to a higher risk classification, which may lead to selection of active therapy. the aim of this study is to investigate positron emission tomography (pet) with the radiolabelled tracer 68ga-nota-ae105, combined with magnetic resonance imaging (mri) in patients with newly diagnosed prostate cancer. 68ga-nota-ae105 targets the receptor urokinase-type plasminogen activator receptor (upar), which is a known marker for aggressive disease in prostate cancer.

Eligibility criteria:
inclusion criteria: * histologically verified prostate cancer * capable of understanding written information and giving informed consent * planned to enter active surveillance strategy or undergo therapy with curative intent (surgery or radiotherapy) exclusion criteria: * obesity (body weight over 140 kg) * known allergy to 68-ga-nota-ae105 * metallic components in the body that contradicts mri scan * severe claustrophobia making the person unable to complete an mri scan
cd4 cell recovery in hiv-1 patients comparing 2 treatment regimes

Conditions: Acquired Immunodeficiency Syndrome; HIV Infections

Summary: therapy guidelines recommend the use of either the non-nucleoside reverse transcriptase inhibitor (nnrti) efavirenz or a ritonavir-boostered protease inhibitor (pi) plus 2 nucleoside reverse transcriptase inhibitors (nrti) as first-line treatment regimes of hiv-1 infection. recent clinical studies suggest potential advantages of nnrti- over pi-based regimes in therapy initiation due to lower rates of virologic failure and less metabolic side-effects. in contrast, pi regimes were claimed to cause greater increases in cd4 cell count than nnrti regimes, which has been attributed to intrinsic antiapoptotic effects of the pi. however, it is still unclear whether the immunological response to a pi-containing regime is greater than to an nnrti-containing regime, whether there is a difference in the extent of reduction of apoptosis between pi and nnrti regimes and whether a difference in apoptosis is associated with a difference in cd4 cell recovery. we conducted a controlled, long-term, random matched pair design study in hiv-1 infected individuals under sustained virologic suppression to evaluate in head-to-head comparison the clinical effects of a constant pi-based or nnrti-based regime on cd4 cell recovery and the underlying molecular, biochemical and functional mechanisms.


Eligibility criteria:
inclusion criteria: * recent, non-acute hiv-1 infection * caucasians * bmi between 17.5 and 30 kg/m2 * cd4 count \<200 cells/µl * plasma viral load \>100,000 hiv-1 rna copies/ml exclusion criteria: * actual or previous antiretroviral therapy * acute illness * coinfection with hbv or hcv * opportunistic infection (pneumocystis jiroveci pneumonia, toxoplasma gondii encephalitis, mycobacterium ssp. infection, syphilis, cryptosporidiosis, cryptococcosis, aspergillosis, cytomegalovirus infection or progressive multifocal leukoencephalopathy) * hepatic or renal disorder * severe cardiovascular disease * hematologic disorder * autoimmune disorder * diabetes mellitus or other severe endocrine disorder * malignancy * neurocognitive disorder * psychiatric disorder * drug or alcohol addiction * chronic drug use (except of blood pressure-lowering or lipid-lowering drugs or proton-pump inhibitors) * any acute medication within 7 days or vaccination within 30 days prior to entry * pregnancy or lactation

Keywords: treatment naive
a study of the clinicopathologic behaviour of the different types of unsafe chronic otitis media

Conditions: Chronic Otitis Media; Cholesteatoma

Summary: the purpose of the study is to study the clinicopathologic behaviour of the 3 dangerous types of chronic otitis media that are prone for complications. in which type are the complications more common? which type gives rise to more hearing loss? how does the disease process in the 3 types evolve? should the 3 types of otitis media be managed differently?

design: prospective cross sectional study setting: tertiary referral medical college hospital no of groups: 3 group 1: primary acquired atticoantral disease group 2: secondary acquired atticoantral disease group 3: mixed atticoantral disease interventions: 1. diagnostic nasal endoscopy 2. eustachian tube function tests 3. pure tone audiometry 4. biopsy of middle ear mucosa 5. culture and sensitivity of ear discharge

Eligibility criteria:
inclusion criteria:1. atticoantral chronic otitis media 2. complicated unsafe otitis media 3. otitis media with cholesteatoma, polyp, granulation tissue 4. ear with retraction pockets leading to attic - exclusion criteria: 1. tubotympanic otitis media alone 2. otitis media with effusion 3. acute otitis media -

Keywords: retraction pockets ear unsafe otitis media otitis media complications
the effects of music on ans and anxiety in healthy elderly and persons with scd

Conditions: Dementia

Summary: subjective cognition decline (scd) is considered as a risk factor of dementia and associates not only with further cognition deterioration but with a higher anxiety level. anxiety may lead to decreasing cognitive function and negative impacts on the well-being and quality of life. to avoid these consequences, reducing anxiety is an important step to treat scd. to ease anxious emotions, music has been viewed as an effective, safe and easy alternative to medication. thus, the purpose of this study is to investigate the effects of music on reducing the anxiety of the healthy elderly and scd and further to compare the anxiety level between scd and healthy controls.

single subject pretest-posttest design was used. 12 scd subjects was recruited from the memory clinic and 12 healthy controls from the community. the anxiety level was assessed both by self-reports (state-trait anxiety inventory and visual analogue scale of anxiety) and by objective measurements related to autonomic nervous system activities (heart rate variability and electrodermal activity). the participants underwent a memory task to induce anxiety. next, preferred music and white noise were provided in random order. the anxiety level and the effects of music intervention between scd and healthy controls will be further compared.

Eligibility criteria:
inclusion criteria: * able to read and write mandarin * the scores of the montreal cognitive assessment (moca) ≥ 24 exclusion criteria: * cognitive status was affected by psychic problems, neurological disease or other conditions * people with auditory and visual impairments * people with obesity (bmi ≥ 27) or diabetes mellitus.

Keywords: music anxiety autonomic nervous system subjective cognition decline
cytokine levels in conversion disorder

Conditions: Conversion Disorder

Summary: the aim of this study is whether the proinflammatory cytokine levels in patients with conversion disorder is increased or not changed in the acute phase and subacute - chronic periode, compared with controls.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of alzheimer's disease exclusion criteria: * autoimmune disease * neurological disease * any organic disorder that could possibly affect proinflammatory cytokines * pregnancy * any drug usage within 2 weeks * any active or passive immunization within 6 months * any other dsm-iv axis i psychiatric disorder * mental retardation * developmental disorder of childhood

Keywords: conversion cytokine inflammation
monitoring of progesterone administered in infertile patients during a cycle of frozen embryo transfer.

Conditions: IVF

Summary: during an in vitro fertilization (ivf) attempt, several embryos are obtained but not all of them can be transferred to the uterus in the same cycle due to the risk of multiple pregnancies. thus, it is very common for these couples to benefit from cryopreservation. patients scheduled for frozen embryo transfer (tec) receive estrogen and progesterone replacement therapy to prepare the endometrium for implantation. data from the literature recently showed that low progesterone on the day of embryo transfer was responsible for a significantly higher rate of implantation failure and miscarriage.


Eligibility criteria:
inclusion criteria: * adult patient undergoing a frozen embryo transfer in an artificial cycle at the amp center of the toulouse university hospital. * affiliation to a social security scheme or equivalent * patient fulfilling the conditions for access to the amp according to french bioethics law * patient having given her consent (oral or written) after clear and fair information exclusion criteria: * patient who received intramuscular administration of progesterone during the endometrial preparation phase. * patient with comprehension difficulties. * protected adult patient (safeguard of justice, guardianship or curatorship)
efficacy and safety of piracetam taken for 12 months in subjects suffering from mild cognitive impairment (mci)

Conditions: Memory Disorders

Summary: the purpose of this study was to explore in a more documented way the relative potential and efficacy of piracetam 9600 and 4800 mg daily.


Eligibility criteria:
inclusion criteria: * male/female between 50 and 89 years (inclusive) * declining cognitive function of at least 3 months duration interfering with complex activities of daily living * normal basic activities of daily independent living * clinical dementia rating scale score equal to 0.5 * score at least one point above the lowest possible score on 7 out of 8 tests in the cognitive battery at both selection visit and baseline visit exclusion criteria: * general anesthetics within 3 months of selection visit * history of severe allergic drug reaction(s) * history of drug or alcohol dependence (dsm iv defined) within the last 12 months * any drug prescribed to activate cerebral metabolism, taken within 1 week of screening or/and concomitantly * concomitant intake of anticoagulent medications * concomitant intake or intake within 1 week before screening of drug that might affect cognitive function or central nervous system * history of dementia, psychiatric or neurological disorders, mental retardation, learning disabilities and stroke * current depression * impaired renal function, thyroid function or neurological degeneration * any gastrointestinal dysfunction that might interfere with the absorption or elimination of the study drug * insulin-dependant diabetes mellitus * bleeding disorders or disturbance in hemostatic function.

Keywords: piracetam nootropil
art therapy intervention for breast cancer patients

Conditions: Breast Cancer

Summary: as studies continue to debate the effects of quality of life on survival, increased attention is being focused on investigating complementary alternative therapies to boost overall total health in cancer patients . art therapy is an interesting growing field, which has shown promise to positively influence quality of life in the pediatric and adult oncology population alike. as there is a paucity of well controlled complete studies in this field, the investigators propose to study the impact of art therapy sessions in women with breast cancer with quantitative and qualitative analysis of emotional health and physical symptoms. the results of the investigators study will have widespread applicability to oncology programs that wish to offer/implement such sessions to their palliative and non-palliative outpatients in an effort to address the important concept of whole person care.


Eligibility criteria:
inclusion criteria: 1. any woman 18-years or older 2. stage i to iii breast cancer (first time diagnosis) 3. minimum of 6 weeks post operative status

Keywords: art therapy breast cancer women young women older women quality of life meaning making support group art making art symbols