Kornimate/medical-research-clean huggingface dataset:
comparing exparel & ropivacaine for pain relief in total knee arthroplasty

Conditions: Knee Osteoarthritis

Summary: the purpose of this prospective study is to examine the effect of two local anesthetics used in adductor canal blocks, with relation to pain, analgesic consumption, mobility, and pain related interference with activities and hospital length of stay. the two agents are bupivacaine and ropivacaine. the purpose of this trial is to examine the effect of these drugs being used in adductor canal blocks for pain relief, analgesic consumption, mobility, and pain related interference with activities and hospital length of stay.

total knee arthroplasty (tka) is associated with intense early postoperative pain. effective pain management following total knee arthroplasty is imperative to facilitate early ambulation, mobilization and rehabilitation. the postoperative pain regimen should enhance functional recovery in addition to providing efficient analgesia with minimal side effects. to manage postoperative pain effectively, multimodal analgesia including acetaminophen, toradol, solu-medrol, opioids and local anesthetics are used. periarticular infiltration performed intra-operatively combined with ultrasound guided adductor-canal peripheral nerve blocks are effective in reducing pain following a tka without causing quadriceps motor block which can impede mobilization. there are no published trials that the investigators could find to date, comparing adductor canal block with a single dose exparel and adductor canal block with standard ropivacaine. a liposome is a manufactured spherical lipid vesicle that can be used to slowly release a drug thereby extending its duration of action. exparel is such a compound that slowly releases bupivacaine. local anesthetics block the conduction of all excitable tissue in a dose related fashion. the first tissues that are affected are nerves, which make these drugs of choice in neural block. their local adverse effects include neurovascular manifestations are prolonged numbness, tingling, feeling of "pins and needles" or strange sensations. these effects are reversed with time. there are no additional potential risks or adverse effects due to the procedures or drugs being administered. the procedure is well established and the local anesthetics have a history of long term use in humans.

Eligibility criteria:
inclusion criteria: * age 18 and up undergoing a total knee replacement with single surgeon. american society of anesthesiologists physical status classification scale (asa) 1-3. exclusion criteria: * allergy to local anesthestic, pre-existing peripheral neuropathy, revision surgery
prognostic value cardiac dysfunction assessed by bedside echocardiography in critically ill copd patients requiring mechanical ventilation

Conditions: COPD Patients; Mechanical Ventilation

Summary: chronic obstructive lung disease (copd) is a major cause of morbidity and mortality, and is a major reason for icu admission. cardiac function is often impaired in this disease but its association with clinical outcome has not been fully established. the study aims to investigate the association between cardiac dysfunction and clinclial outcomes.

this is a prospective observational study conducted in a 47-bed mixed icu of tertiary academic teaching hospital. the study will be performed between january 2014 to december 2015. all patients meeting the diagnostic criteria of aecopd and admitted to icu are potentially eligible for the present study. relevant demographics and laboratory measurements are obtained. transthoracic echocardiography (tte) is performed immediately after icu admission by experienced intensivists. cox proportional hazard regression model is fitted by using stepwise forward selection and backward elimination technique. if linear assumption is not satisfied, the linear spline function will be used.

Eligibility criteria:
inclusion criteria: * copd patients experiencing episode of exacerbation and require mechanical ventilation were admitted to icu exclusion criteria: * copd patients admitted to icu due to other reasons (major surgery, ischemic heart disease, and renal failure) * moribund and expected to die within 48 hours * with do-not-resuscitation order
comparison of bizact with electroscissor for tonsillectomy

Conditions: Tonsillar Hypertrophy, Tonsillitis

Summary: in a randomized, partly double-blind prospective setup we want to compare traditional adult electro-scissor tonsillectomy with ultrasound technology, bizact.


Eligibility criteria:
inclusion criteria: * planned elective tonsillectomy * informed consent exclusion criteria: * regular use of analgesics pre-operatively * known tendency of bleeding * not able to communicate in norwegian
covid-19 infection and idiopathic membranous nephropathy

Conditions: Idiopathic Membranous Nephropathy

Summary: infection is one of common risk factors for relapsing of idiopathic membranous nephropathy (imn). however, it is still unclear wheather covid-19 infection can induce the relapsing of imn. herein, in this prospective, multi-center, cohort study, the investigator enrolled the imn patients with covid-19 infection. all subjects will be followed for three months with four visits at 1, 2 and 3 months. then the investigator will compare the rate of replase of imn in the two groups to evaluate the association of covid-19 infection and replapse of imn.


Eligibility criteria:
inclusion criteria: 1. the status of nephrotic syndrome is complete remmision or partial remmision; 2. estimated glomerular filtration rate (egfr according to the ckd-epi formula) ≥60 ml/min per 1.73 m2; 3. patients with a moderate risk of imn. exclusion criteria: 1. secondary causes of mn; 2. the labarotary data two months before enrolement is absent.
rituximab in treating young patients who are receiving chemotherapy for b-cell non-hodgkin's lymphoma or b-cell acute lymphoblastic leukemia

Conditions: Leukemia; Lymphoma

Summary: rationale: monoclonal antibodies, such as rituximab, can block cancer growth in different ways. some find cancer cells and kill them or carry cancer-killing substances to them. others interfere with the ability of cancer cells to grow and spread. giving rituximab before chemotherapy may be an effective treatment for b-cell non-hodgkin's lymphoma or b-cell acute lymphoblastic leukemia. purpose: this phase ii trial is studying how well rituximab works in treating young patients who are planning to receive chemotherapy for b-cell non-hodgkin's lymphoma or b-cell acute lymphoblastic leukemia.

objectives: * determine the response rate in children and adolescents with b-cell non-hodgkin's lymphoma (b-nhl) or b-cell acute lymphoblastic leukemia (b-all) treated with rituximab monotherapy as upfront window therapy before chemotherapy. * evaluate the effect of rituximab on different histological subtypes of childhood mature b-nhl or b-all in patients treated with this regimen. * investigate the rituximab response in patients treated with this regimen. * determine the toxicity profile of rituximab in these patients. * collect pharmacokinetic and pharmacodynamic data from patients treated with this regimen. outline: this is a multicenter study. patients receive rituximab iv on day 1. projected accrual: a total of 79 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * histologically and immunohistochemically or cytomorphologically and immunphenotypically confirmed mature b-cell non-hodgkin's lymphoma or b-cell acute lymphoblastic leukemia * cd20 positive disease patient characteristics: * not pregnant or nursing * fertile patients must use effective contraception * adequate general condition with sufficient organ function (hepatic, renal, and cardiac) * no known disease that would preclude protocol therapy with rituximab * no known allergies against proteins * no acute or previous hepatitis b infection prior concurrent therapy: * at least 2 weeks since prior corticosteroids * no prior radiotherapy * no prior or concurrent chemotherapy * no concurrent treatment in another investigational trial

Keywords: b-cell childhood acute lymphoblastic leukemia untreated childhood acute lymphoblastic leukemia stage i childhood large cell lymphoma stage ii childhood large cell lymphoma stage iii childhood large cell lymphoma stage iv childhood large cell lymphoma stage i childhood lymphoblastic lymphoma stage ii childhood lymphoblastic lymphoma stage iii childhood lymphoblastic lymphoma stage iv childhood lymphoblastic lymphoma stage i childhood small noncleaved cell lymphoma stage ii childhood small noncleaved cell lymphoma stage iii childhood small noncleaved cell lymphoma stage iv childhood small noncleaved cell lymphoma
lactobacillus reuteri for prevention of necrotizing enterocolitis in very low-birth weight infants

Conditions: Necrotizing Enterocolitis; Very Low Birth Weight Infants

Summary: probiotics are favorable microorganisms that regulate the flora of the gastrointestinal system and stimulate the immune system. necrotizing enterocolitis incidence is 10-25% in newborn infants whose birth weights are \< 1500 g. although bifidobacterium and other lactobacilli spp. have been used to reduce the incidence of necrotizing enterocolitis in clinical trials, lactobacillus reuteri has not been used in the prevention of necrotizing enterocolitis in very low birth weight infants yet. the objective of this study is to evaluate the efficacy of orally administered lactobacillus reuteri in reducing the incidence and severity of necrotizing enterocolitis in very low birth weight infants.


Eligibility criteria:
inclusion criteria: * very low birth weight infants \< 1500 gr * gestational age \< 32 weeks exclusion criteria: * genetic anomalies * short bowel syndrome * not willing to participate * allergy to lactobacillus reuteri components
improving care for community acquired pneumonia 1 (ice-cap2)

Conditions: Pneumonia Childhood

Summary: children with pneumonia presenting to the emergency department at monroe carell jr. children's hospital at vanderbilt or children's hospital of pittsburgh will be potentially eligible for study. during intervention periods, providers caring for enrolled children will be presented with a detailed decision support strategy that emphasizes management in accordance with national guideline recommendations. the anticipated study duration is 24 months and, as this study does not include direct contact with enrolled subjects, there is no anticipated follow up.

pneumonia is the most common serious infection in childhood. in the united states (us), pneumonia accounts for 1-4% of all emergency department (ed) visits in children (3-28 per 1,000 us children per year) and ranks among the top 3 reasons for pediatric hospitalization with \>100,000 hospitalizations per year (15-22 per 100,000 us children per year). pneumonia also accounts for more days of antibiotic use in us children's hospitals than any other condition. emergency care for childhood pneumonia, including hospitalization rates, varies widely across the nation. a study examining hospital admission rates at 35 us children's hospitals from 2009-12 showed marked differences in severity-adjusted pneumonia hospital admission rates (median 31%; range 19-69%). provider preferences and inaccurate risk perceptions contribute to these differences in hospitalization rates. within the intermountain healthcare system in utah, dean et al. exposed large differences in admission rates (range 38-79%) among 18 individual ed providers providing care for \>2,000 adults with pneumonia. differences were not explained by patient characteristics or illness severity and higher rates of hospitalization did not reduce hospital readmissions or mortality. in another multicenter study of 472 adults with pneumonia at \<4% risk of 30-day mortality estimated using objective severity scores, providers overestimated the risk of mortality in 5% of outpatients (range across institutions 0-12%) and 41% of inpatients (range across institutions 36-48%). these studies suggest that risk perceptions are often inaccurate, and potentially lead to unnecessary or prolonged hospitalizations and intensive therapies. similar studies have not been performed in children because no valid prognostic tools exist to reliably predict pediatric pneumonia severity.

Eligibility criteria:
inclusion criteria: 1. six months to \<18 years of age 2. radiographic evidence of pneumonia in ed 3. provider-confirmed diagnosis of pneumonia exclusion criteria: 1. children with tracheostomy, cystic fibrosis, immunosuppression 2. inter-hospital transfers 3. hospitalization within preceding 7 days 4. previously enrolled within preceding 28 days 5. provider preference for any reason
proximal strengthening for the management of wrist pain

Conditions: Wrist Injuries

Summary: this study will be a randomized controlled trial comparing proximal strengthening vs. traditional hand therapy for patients with wrist pain. patients will attend 2 hand therapy sessions per week for 4 weeks. change in patient function and pain as measured by the patient rated wrist evaluation will be the primary outcome of interest

this will be a non-blinded randomized controlled trial using a sample of consecutive patients with wrist pain. patients who are referred to nationwide children's hospital hand therapy clinics with a primary complaint of wrist pain will be considered for this study. patients will be randomly assigned to one of two treatment groups; the proximal strengthening group or traditional hand therapy group. both treatment groups will be evaluated and treated by the certified hand therapists for 2 sessions per week for 4 weeks. both groups will receive similar treatment durations of 45-60 minutes per session based on each patient's individual needs. proximal strengthening group-the experimental proximal strengthening group consists of treatment where the hand therapist address specific impairments at the wrist and hand for 20-30 minutes at each treatment session. patients allocated to this treatment group will also perform a standardized proximal strengthening protocol consisting of cervical, periscapular, and shoulder strengthening exercises. depending on the pace and guidance needed for these exercises 25-30 minutes will be spent on proximal strengthening exercises. as the patients endurance and strength increased the repetitions and/or resistance of these exercises will increase. traditional hand therapy group this active comparator group consists of treatment where the hand therapist address specific impairments at the wrist and hand for 45-60 minutes at each treatment session. treatment can include stretching, motion, and strengthening exercises. as the patients endurance and strength increased the repetitions and/or resistance of these exercises will increase. modalities for pain control and tissue mobility, and bracing or splinting if necessary. all treatments for the traditional hand therapy treatment group will occur seated at the hand therapy treatment table.

Eligibility criteria:
inclusion criteria: * wrist pain exclusion criteria: * \<8 years of age * any neurological disorder * juvenile rheumatoid arthritis * juvenile idiopathic arthritis * wrist fractures \< 16 weeks from date of injury or surgery * tendon repair * nerve injury or repair * inability to follow directions * inability to attend follow-up appointments

Keywords: wrist proximal strengthening hand therapy
assessment of the subcutaneous reinjection of human autologous adipose-derived stromal vascular fraction (celution® system) in the hands of patients suffering from systemic sclerosis

Conditions: Systemic Sclerosis

Summary: systemic sclerosis is an autoimmune disease characterized by skin lesions and visceral responsible for significant morbidity. microcirculatory disorders and tissue fibrosis are excessive severity of the disease. this condition can affect the hands with a major functional consequence severely impairing the quality of life of patients. adipose tissue is used in plastic surgery for over a century for the filling of depressions in the skin. in addition to the volume effect, a trophic effect on the surrounding tissue was noted. it is shown that the stromal vascular fraction is responsible for this regenerative effect. in a previous study the investigators have demonstrated in a mouse model that the subcutaneous adipose tissue provides a trophic effect on ssc skin lesions by reducing the fibrosis of the dermis and providing a pro angiogenic. objectives and means: this is a clinical study evaluating an innovative cell therapy procedure. the objective of this study was to evaluate the effects of injection of autologous stromal vascular fraction of adipose origin according to the system celution ® (cytori therapeutics, inc.., united kingdom) in digital in patients with scleroderma cutaneous hands. eleven patients with scleroderma with the hands will be included in the study. due to the nature of the orphan disease, a longitudinal study be conducted, where each patient will have own control. the evaluation will be pre and post operative for a period of six months. this evaluation will be based on clinical criteria (trophic balance, functional) and laboratory (capillaroscopy, doppler ultrasound of the arteries of the forearm, laser-doppler tissue). project schedule and implementation phases: the project will run over a period of twelve months. patients will be followed for a period of six months. analyzes clinical, paraclinical, and exploitation of results will be achieved over a period of six months. expected results: this study will validate the functional and trophic effects of reinjection of autologous stromal vascular fraction of adipose tissue issue on the fingers of patients with scleroderma. conclusion: this innovative cell therapy could represent an alternative treatment for patients with scleroderma in check, intolerant or insufficiently relieved by medical treatment currently available in the scleroderma hand


Eligibility criteria:
inclusion criteria: * men and women of more than 18 years old wishing a therapeutic alternative. * functional disability of the hand authenticated by a functional index of the hand of cochin upper to 20. exclusion criteria: * persons participating simultaneously in another biomedical search(research) * minors * pregnant or breast-feeding women * major persons protected by the law (under guardianship or guardianship) * persons staying in a sanitary or social establishment * persons in emergency situation * private persons of freedom
transdermal continuous oxygen therapy for infection prophylaxis in high- risk patients undergoing instrumented fusion

Conditions: Instrumented Spinal Fusion

Summary: epiflo® unit along with standard wound care vs only standard wound care for surgical site infections (ssi).

surgical site infections (ssi) after instrumented spinal fusions are not rare, and patients with ssi after instrumented spinal surgery often require repeat operations and prolonged intravenous antibiotic therapy. wound hypoxia has been identified as a pathogenic mechanism behind wound infection and poor healing. transdermal oxygen delivery (epiflo) has recently become a novel strategy to facilitate wound healing. the study doctor will give an epiflo® unit along with standard wound care to some subjects in this study to see if it is safe and can help them. another purpose of this study is to find out if using epiflo® is better than getting only standard wound care for surgical site infections (ssi). the sponsor also wants to compare the cost of using the study device and standard wound care to the cost of standard wound care alone. the u.s. food and drug administration (fda) has approved epiflo® to treat skin ulcers (including diabetic skin ulcers), bedsores, amputations, skin grafts, burns, and frostbite.

Eligibility criteria:
inclusion criteria: * elective spinal fusion - posterior cervical, posterior thoracic, or posterior lumbar instrumented spinal fusions * patient age 18-80 * patients must be considered high risk for infection, meeting one or more of the following criteria: * anticipated surgical duration ≥ 3 hours * diabetes mellitus type i or ii * anesthesiology asa score of 3 or above * bmi ≥35 * patients with malnutrition as indicated by pre-albumin value of \<20 * chronic corticosteroid use * smokers * patients on immune modulators exclusion criteria: major study exclusion criteria include: * pregnancy * active infection at the time of surgery * persons with decubitus or diabetic ulcers * patients undergoing \>5 level fusion (level is defined as crossing a disk space; e.g.,an l3-5 fusion is a 2 level fusion) * disseminated cancer patients

Keywords: instrumented spinal fusion infection topical oxygen
randomized, double-blind, placebo-controlled, forced-titration, comparing telmisartan vs valsartan. taken orally for eight weeks in patients with stage 1 and stage 2 hypertension

Conditions: Hypertension

Summary: the primary objective of this study is to compare the effectiveness of telmisartan 80 mg / hydrochlorothiazide 25 mg \[micardis hct\] to valsartan 160 mg / hydrochlorothiazide 25 mg \[diovan hct\] and placebo in the treatment of stage 1 and stage 2 hypertension.


Eligibility criteria:
inclusion criteria: 1. ability to provide written informed consent. 2. age 18 years or older 3. ability to stop current antihypertensive therapy without unacceptable risk to the patient (investigator's discretion) 4. seated cuff dbp of ? 95 mmhg at visit 2 (baseline) exclusion criteria: 1. pre-menopausal women (last menstruation ? 1 year prior to start of run-in period) who: 1. are not surgically sterile and/or 2. are nursing or pregnant 3. are of child-bearing potential and are not practicing acceptable means of birth control, do not plan to continue using this method throughout the study and do not agree to submit to periodic pregnancy testing during participation in studies of \> 3-months duration. acceptable methods of birth control include oral, implantable, transdermal, or injectable contraceptives, and intra-uterine device (iud). 2. known or suspected secondary hypertension. 3. mean seated sbp \>= 180 mmhg or mean seated dbp \>= 120 mmhg during any clinic visit prior to randomization. 4. hepatic and/or renal dysfunction as defined by the following laboratory parameters: 1. sgpt (alt) or sgot (ast) \> 2 times the upper limit of normal range, or 2. serum creatinine \> 3.0 mg/dl or creatinine clearance \< 0.6 ml/sec. 5. bilateral renal artery stenosis, renal artery stenosis in a solitary kidney, post-renal transplant or with only one kidney. 6. clinically relevant hypokalemia or hyperkalemia. 7. uncorrected volume depletion. 8. uncorrected sodium depletion. 9. primary aldosteronism. 10. hereditary fructose intolerance. 11. biliary obstructive disorders, cholestatis or moderate to severe hepatic in sufficiency. 12. patients who have previously experienced symptoms characteristic of angioedema during treatment with ace inhibitors or angiotensin ii receptor antagonists. 13. history of drug or alcohol dependency within six months prior to start of run-in period. 14. chronic administration of any medications known to affect blood pressure, exc
access to chiropractic care during the covid-19 pandemic

Conditions: Access to Chiropractic Care Services

Summary: this is a prospective comparative cohort trial taking place during the first year of the coronavirus-19 (covid-19) pandemic in spain. chiropractic patients throughout spain were invited to participate independently of the care received, including patients who had stopped visiting their chiropractors since the pandemic hit. the main exposure variable is the access to chiropractic care services, and the degree of this exposure during the months following initial lockdown phase in spain. participants will fill an online questionnaire with self-reported outcome-measures.


Eligibility criteria:
inclusion criteria: * chiropractic patients with pain, active when lockdown was declared, over the age of 16 exclusion criteria: * new patients in the clinic after the pandemic hit