Kornimate/medical-research-clean huggingface dataset:
goal-directed analgesia using ani during general anesthesia in children with moyamoya disease

Conditions: Pain

Summary: analgesia nociception index (ani) has been proposed for the evaluation of the nociception-antinociception balance in the perioperative period. in pediatric patients with moyamoay disease, where the management of analgesia may be rendered difficult by pharmacological changes, we hypothesised that the monitoring of analgesia with ani would reduce intraoperative opioid consumption during edas surgery.


Eligibility criteria:
inclusion criteria: * pediatric patients receiving edas surgery for moyamoya disease exclusion criteria: * asa (american society of anesthsiologists classification) 4-5 * emergency surgery * patients with chronic pain on medication
dopexamine and norepinephrine compared with epinephrine alone in septic shock

Conditions: Septic Shock

Summary: in septic shock, when volume resuscitation fails to restore mean arterial pressure, catecholamines such as dopamine, dobutamine, epinephrine, or norepinephrine are used, either alone or in combination. although they allow hemodynamic success to be obtained, they can leave some regional blood flows impaired, especially the hepatosplanchnic perfusion, which contributes to multiple organ failure. dopexamine is a structural and synthetic analog of dopamine that exerts systemic and gut vasodilation and stimulates cardiac contraction. in experimental models, dopexamine has been shown to exert anti-inflammatory properties and to protect the hepatic ultra structure. the combination of dopexamine and norepinephrine could therefore constitute an interesting alternative in treating septic shock patients. this study will test the efficacy (on gastric mucosal blood flow, hepatic damage and oxidative stress) and safety of the combination of dopexamine and norepinephrine (compared to those of epinephrine alone) in the treatment of patients with septic shock.

objective: to compare the combination of dopexamine and norepinephrine with epinephrine alone on gastric mucosal blood flow (gmbf), hepatic damage and oxidative stress in septic shock. setting: surgical intensive care unit in a university hospital. design: prospective, randomized, controlled study on 2 parallel groups. patients: adults fulfilling usual criteria for septic shock. interventions: systemic hemodynamics, gmbf (laser-doppler), plasma α-glutathione s-transferase, aspartate aminotransferase, alanine aminotransferase and malondialdehyde were assessed just before catecholamine infusion (t0), as soon as mean arterial pressure (map) reached 70-80 mmhg (t1), and 2 (t2) and 6 (t3) hours after t1. drugs were titrated from 0.2 µg/kg/min with 0.2 µg/kg/min increments every 3 min for epinephrine and norepinephrine, and from 0.5 µg/kg/min with 0.5 µg/kg/min increments every 3 min for dopexamine.

Eligibility criteria:
inclusion criteria: * adults over 18 years * informed consent * septic shock with: * evidence of infection; * at least 3 of the following criteria: temperature \> 38°c or \ 20 breaths per minute or paco2 \ 90 beats/min; white blood cell count \> 12,000/mm3 or \< 4,000/mm3; * at least 2 of the following criteria: plasma lactate \> 2 mmol/l or unexplained metabolic acidosis (ph \ 10 μg/ml); * systolic blood pressure \ 12 mmhg. exclusion criteria: * pregnant women * patients with a history of esophageal or gastric disease * patients with a history of esophageal or gastric surgery

Keywords: splanchnic perfusion, hepatic damage, oxidative stress.
neuromuscular electrical stimulation in acute ischemic stroke

Conditions: Ischemic Stroke; Neuromuscular Electrical Stimulation; Exercise

Summary: the purpose of the study is to examine the added effect of neuromuscular electric stimulation (nmes) in addition to exercise therapy in the acute phase of ischemic stroke. this randomized controlled trial includes 50 patients allocated to either control or intervention. the inclusion, test, training and re-test will be provided during the first 14 days after ictus, starting day 1 or 2 after ictus and a follow-up at day 90. the exercise training with external nmes is done with the patient every weekday for 12 minutes.

stroke is the third most cause of disability in adults over 65 years of age worldwide. in 2008, 30.7 million people had survived a stroke. every year, there are about 14,000 new cases of stroke in denmark and the number is expected to rise with about 40% by 2035, due to the increasing population of elderly. stroke survivors have the worst odds of reporting severe disability and the greatest variety of individual domains of disability compared to a range of other diseases. therefore, these patients have essential rehabilitation needs. little is known about who will benefit from functional interventional rehabilitation and what kind of intervention is best. the purpose of the study is to examine the added effect of neuromuscular electric stimulation (nmes) in addition to exercise therapy in the acute phase of ischemic stroke. this rct includes 50 patients allocated to either control or intervention. the inclusion, test, training and re-test will be provided during the first 14 days after ictus, starting day 1 after ictus and a follow-up at day 90. the exercise training with external nmes is done with the patient every weekday for 12 minutes. if nmes increases functionality in acute stroke patients it would mean a greater degree of independence for individual patients and thus have the potential to improve on a major problem for society. by combining comorbidity, stroke severity, and other demographic data it might be possible to get a greater knowledge about who will benefit from the intervention and early rehabilitation and that will be the a step towards "personalized medicine" in stroke rehabilitation.

Eligibility criteria:
inclusion criteria: * acute ischemic apoplexy and paresis in lower extremity, verified with picture diagnosis (ct/mr) or clinically diagnosed. * leg palsy equalizes 2-4 * modified ranking scale(mrs) =0-1 * cognitive function adequate to participate exclusion criteria: * patients with dementia and/or malign diseases * pregnancy * epilepsy * total loss of sensation * pacemaker * previous or current blood clot in the leg * untreated depression * untreated alcohol or drug abuse * untreated hypertension * heart disease which limits function

Keywords: ischemic stroke neuromuscular electrical stimulation activities of daily living patient reported outcome fugl meyer
role of tlr2 and tlr4 in stage 2 periodontitis patients

Conditions: Periodontal Inflammation

Summary: in health, mucosal inflammation is prevented by tlr (toll like receptors) that interact with specific mamp (microbe associated molecular pattern). currently about 13tlrs have been identified. among them, tlr2 and 4 recognize most organisms . periodontal disease is mixed infection resulting due to dysbiosis . when aggravated by systemic disease the role of tlrs is detrimental for the overall state of periodontal apparatus. type 2 diabetes is one of the systemic disease which is seen a risk factor if uncontrolled can exaggerate the titer of tlr2 and tlr4 biomarkers . various studies have been evaluated to determine the role of tlrs in autoimmune and periodontal conditions. the purpose of this study is to determine if both tlr2 and tlr4 play equal roles in periodontal disease and in cases where periodontal disease is complicated by the presence of systemic disease. individual role of tlr2 and tlr4 in active disease will help determine treatment strategies and will also be able to predict potential biomarker in disease.

in health, mucosal inflammation is prevented by tlr (toll like receptors) that interact with specific mamp (microbe associated molecular pattern). currently about 13tlrs have been identified. among them, tlr2 and 4 recognize most organisms. periodontal disease is mixed infection resulting due to dysbiosis. when aggravated by systemic disease the role of tlrs is detrimental for the overall state of periodontal apparatus. type 2 diabetes is one of the systemic disease which is seen a risk factor if uncontrolled can exaggerate the titer of tlr2 and tlr4 biomarkers. various studies have been evaluated to determine the role of tlrs in autoimmune and periodontal conditions. the purpose of this study is to determine if both tlr2 and tlr4 play equal roles in periodontal disease and in cases where periodontal disease is complicated by the presence of systemic disease. individual role of tlr2 and tlr4 in active disease will help determine treatment strategies and will also be able to predict potential biomarker in disease. periodontal diseases are classified according to the american academy of periodontology as stage 1, 2, 3\&4 according to severity and extent of the disease progression. stage 2 periodontitis was selected as it is considered as an intermediary, because cal(clinical attachment loss was standardized at 3-4mm,this could reflect the progression of disease and its impact from a horizontal bone loss to a more oblique one, if in case the dysbiosis persists.

Eligibility criteria:
inclusion criteria: * \*untreated stage 2 periodontitis patients (n-60)-age group 21-60 * non smokers * diabetic patients controlled * not haven taken medications in the past 3 months exclusion criteria: * smoker * habits such as betel, tobacco chewing * systemically unstable, diabetes uncontrolled patients * haven taken medications in the past 3 months * pregnant ladies * periodontal involvement
rosa® knee system v1.5 pilot study

Conditions: Knee Arthroplasty, Total; Robotic Surgical Procedures; Joint Diseases; Knee Osteoarthritis

Summary: this pilot study seeks to evaluate the initial safety and usability of new features for the rosa® knee system, v1.5 and plan design modifications as needed. the primary objectives will be assessed by measuring: 1. intra-operative complications 2. verification that the device performs as intended 3. overall surgeon satisfaction with the instrumentation.

this study will involve single-arm, monocentric, cross-sectional observations conducted on the day of surgery. all assessments will take place during the pre-operative, intra-operative, and immediate postop periods on the day of surgery, with no additional follow-up beyond the procedure as robotic-assisted surgery using the current version of the robot is part of routine practice. the safety of the system is the primary endpoint. this will be assessed by monitoring the frequency and incidence of adverse events. relation of the events to implant, instrumentation and/or procedure should be specified. the secondary endpoint is defined by the usability of zimmer biomet rosa® knee system, v1.5. it will be assessed by: 1. robotic log files to assess differences in the proposed plans by the system's new features and plan approved by the surgeon, along with time spent in the planning panel. 2. surgeon satisfaction with the new features.

Eligibility criteria:
inclusion criteria: * patient is a minimum of 18 years of age * independent of study participation, patient is a candidate for primary total knee arthroplasty using commercially available and compatible implants in accordance with product labeling * patient is willing and able to provide written informed consent by signing and dating the ec approved informed consent form exclusion criteria: * patient is currently participating in any other surgical intervention studies or pain management studies * patient is pregnant or considered a member of a protected population (e.g., prisoner, mentally incompetent, etc.) * patient has previously received partial or total knee arthroplasty for the ipsilateral knee
hidradenitis suppurativa wound care

Conditions: Hidradenitis Suppurativa (HS)

Summary: the objective of this case series is to monitor time and outcome of healing of wounds associated with hs using endoform \[ovine forestomach\], hydrofera blue \[methylene blue and gentian violet\], and hypafix tape. a combination methylene blue, gentian violet, and ovine forestomach wound care product.

hidradenitis suppurativa (hs) is a chronic and debilitating inflammatory disease most frequently affecting the axilla, groin, and inframammary regions. symptoms include nodules, abscesses, sinus tract formation, malodorous drainage, and scarring. these symptoms interfere with everyday activities, which can lead to social embarrassment and isolation. patients with hs suffer psychological effects, such as increased levels of anxiety, depression, and loneliness, which impair quality of life. patients suffer with the burden of at home wound care for recurrent, draining nodules. persistent lesions affect patients' lives by limiting their daily activities. currently, patients are instructed to use gauze and tape to cover draining wounds, but this can be insufficient and difficult due to the nature and location of lesions associated with hs. patients suffer with caring for their wounds, which can lead to frustration. providing patients with a standard wound care regimen to take home can improve patients' quality of life and control of their disease. general recommendations for wound care in hs patients are limited. improvements in the standard of care for wound management in hs are needed to aid patients.

Eligibility criteria:
inclusion criteria: * individuals with hidradenitis suppurativa with non-healing wounds or draining abscesses/nodules * individuals over 18 years of age exclusion criteria: * individuals younger than 18 years of age * individuals without a diagnosis of hs
twelve month follow-up of cp0108

Conditions: Actinic Keratosis

Summary: the purpose of this study is to determine the long-term safety and efficacy of levulan pdt in subjects with multiple actinic keratosis of the upper extremities who received treatment as part of the dusa cp0108 study.


Eligibility criteria:
inclusion criteria: * subject must have been enrolled in the dusa-cp0108 study, completed their assigned treatment and visit 6 (week 12).

Keywords: actinic keratosis
the effect of fluticasone/salmeterol combination on exertional breathlessness in patients with mild copd

Conditions: COPD

Summary: even patients with milder copd can have significant physiological abnormalities which become more pronounced during exercise, leading to intolerable breathing discomfort (dyspnea). while there is a compelling physiological rationale for the efficacy of inhaled corticosteroid/long-acting bronchodilator combination therapy \[i.e., fluticasone 250μg/salmeterol 50μg (fsc250/50)\] in moderate to severe copd, little information is available on the potential impact of this therapy in milder symptomatic disease. this study will be the first to explore mechanisms of dyspnea and activity limitation in milder copd and will determine if there is a sound physiological rationale for the use of fsc as therapy for this subpopulation.


Eligibility criteria:
inclusion criteria: * stable mild copd, * fev1/fvc\ 60% predicted, * activity-related dyspnea (i.e., baseline dyspnea index focal score \ 2), * cigarette smoking history ≥20 pack-years. exclusion criteria: * presence of a significant disease other than copd that could contribute to dyspnea and exercise limitation, * important contraindications to clinical exercise testing, * use of daytime oxygen, * history of asthma.

Keywords: mild copd dyspnea exercise combination therapy
etreat study on effectiveness of botulinum toxin type a injections to treat post-stroke upper and/or lower limb spasticity

Conditions: Spasticity

Summary: the objective of this study is to evaluate the effectiveness of bont-a on functional improvement in patients with post-stroke upper and/or lower limb spasticity in the early stage of spasticity development, according to routine clinical practice.


Eligibility criteria:
inclusion criteria: * men and women ≥ 18-80 years. * poststroke limb spasticity. * patients who have suffered a stroke in the previous 6 months. * treatment goal has been previously agreed with the patient or their legal representative. * patients with clinically significant poststroke upper/lower limb spasticity, in whom it has been decided to perform multidisciplinary treatment with bont-a + rehabilitation. * no previous treatment with bont-a. * patient is able to follow the protocol. * written informed consent. exclusion criteria: * neuromuscular disease. * use of drugs that interfere with neuromuscular transmission. * any other condition that could interfere with rehabilitation or evaluation of the results. * diagnosis of spasticity not associated with stroke. * pregnant or nursing mothers. * prior participation in any other study in the 6 months before study entry
comparative randomized study of the efficacy, safety, and toleration of fluconazole oral suspension or nystatin oral suspension in the treatment of patients with oropharyngeal candidiasis in association with the acquired immunodeficiency syndrome

Conditions: Candidiasis, Oral; HIV Infections

Summary: to compare the efficacy, safety, and toleration of fluconazole as a single daily oral suspension for 14 days versus nystatin oral suspension 4 times daily for 14 days in the treatment of oropharyngeal candidiasis in patients with aids or hiv infection.

patients are randomized to receive fluconazole oral suspension once daily (swallowed at approximately the same time every day) for 14 days or nystatin oral suspension used to rinse the mouth four times daily for 14 days. no food or drink is permitted immediately following the administration of the nystatin.

Eligibility criteria:
inclusion criteria concurrent medication: allowed: * phenytoin. * oral hypoglycemics. * coumarin-type anticoagulants. * cyclosporine. patients must have: * arc or aids. * signs of oropharyngeal candidiasis (i.e., typical white plaques) with some associated symptoms. * confirmation of diagnosis by microscopic exam and culture of organism. * life expectancy of at least 4 weeks. note: * patients with signs or symptoms of esophagitis (e.g., odynophagia) are not eligible unless esophagoscopy is performed and results are negative. exclusion criteria co-existing condition: patients with the following conditions are excluded: * unable to tolerate oral medication. * concurrent enrollment on another experimental trial of approved or non-approved drugs or systemic compounds (without approval of pfizer clinical monitor). concurrent medication: excluded: * antifungal agents other than study drugs. * other experimental medications. patients with the following prior conditions are excluded: known history of intolerance or allergy to imidazoles or triazoles or the polyene components of nystatin. prior medication: excluded: * other antifungal agents within the past 3 days.

Keywords: nystatin fluconazole acquired immunodeficiency syndrome aids-related complex candidiasis, oral
evaluation of single ascending doses of subcutaneous exendin 9-39 in patients with post-bariatric hypoglycemia

Conditions: Hyperinsulinemia Hypoglycemia

Summary: this study is designed to evaluate the safety, efficacy, and pharmacokinetic profile of single ascending doses of exendin 9-39 administered by subcutaneous route in subjects with post-bariatric hypoglycemia.

post-bariatric hypoglycemia (pbh) is a debilitating rare disease afflicting 0.2-6.9% of post-bariatric patients, characterized by repeated severe hypoglycemic episodes with neuroglycopenic symptoms and marked disability. there are no effective medical therapies. while the cause is not known, exaggerated postprandial secretion of glucagon-like peptide-1 (glp-1) as a result of altered nutrient transit likely plays a major role. glp-1 is an incretin hormone secreted primarily by the distal ileum that contributes to postprandial glucose regulation. exendin 9-39 (ex9) is a specific glp-1 receptor antagonist, that when given via continuous iv infusion, has been shown to effectively prevent postprandial hypoglycemia in patients with pbh. subcutaneous (sc) injection of ex9 may represent a safe, effective and practical therapeutic approach to treating pbh.

Eligibility criteria:
inclusion criteria: * post-bariatric surgery more than 6 months prior to signing the informed consent * reported history of whipple's triad: the occurrence of hypoglycemic symptoms associated with blood glucose of ≤55 mg/dl, and resolution with glucose or carbohydrate administration. * symptomatic hypoglycemia during the baseline/screening ogtt, as defined by the presence of plasma glucose ≤55 mg/dl with concomitant autonomic and/or neuroglycopenic symptoms. exclusion criteria: * patients currently using sulfonylureas or other medications that may interfere with glucose metabolism within 5 half-lives of drug. * participation in any clinical investigation within 4 weeks prior to dosing * history of or current insulinoma * active infection or significant acute illness within 2 weeks prior to dosing * female patients who are pregnant or lactating * women of childbearing potential and not utilizing effective contraceptive methods * inadequate end organ function

Keywords: post-bariatric hypoglycemia non-insulinoma pancreatogenous hypoglycemia syndrome late dumping syndrome
interobserver variability desmoplasia

Conditions: Cutaneous Squamous Cell Carcinoma; Pathology; Recurrence; Metastasis

Summary: according to the most recent guideline of the national comprehensive cancer network (nccn), desmoplasia is considered to be a very high risk factor for recurrence, metastasis and death in cutaneous squamous cell carcinoma (cscc). the presence of desmoplasia is assessed by dermatopathologists during histological examination of csccs. however, the inter-observer agreement is between dermatopathologists in the assessment of desmoplasia is unclear. studies on inter-observer variability in the assessment of differentiation grade in csccs showed that there is only a weak to moderate agreement among dermatopathologists in the assessment of differentiation grade (2-4). this study aims to investigate the interobserver agreement of desmoplasia between dermatopathologists. in this prospective study, 50 csccs will be assessed for desmoplasia by at least eight dermatopathologists using a predefined definition.


Eligibility criteria:
inclusion criteria: * histological coupes of patients with a cscc between 2010 and 2018 (both cscc with and without desmoplasia are included) * treated at the maastricht university medical center+ (mumc+)in maastricht for their cscc * of which the histology is available in the mumc+ exclusion criteria: - none

Keywords: interobserver variability interobserver agreement reproducibility dermatopathologist desmoplasia