Kornimate/medical-research-clean huggingface dataset:
perioperative gabapentin use in head and neck mucosal surgery patients

Conditions: Head and Neck Cancer; Acute Pain; Postoperative Pain

Summary: patient satisfaction with healthcare is increasingly being utilized as a metric to reflect provider and hospital quality of care. furthermore, at the core of a healthcare team and healthcare system is the desire to provide patients with the best possible care in order to achieve the best possible outcomes. providers have the duty to identify areas of needed improvement within the domains of treatment. an area of need that is ubiquitous within medicine is pain control; in this case acute postoperative pain control is the targeted condition. studies have already shown that better control of acute postoperative pain leads to shortened hospital stays, reduced hospital costs and patient morbidity, improved patient satisfaction and a reduced likelihood of developing chronic pain. research within the field of pain management has definitively revealed that a combination of different medication regimens can control acute postoperative pain better than narcotics alone. in particular, the medication gabapentin has been shown to improve acute postop pain in many kinds of surgical settings, and it is a safe medication with arguably fewer side effects than narcotics. the investigators know that certain groups of post surgical otolaryngology patients can be at risk for high levels of postoperative pain. given all of this information, physicians have a responsibility to utilize medications such as gabapentin to do a better job of controlling patient's pain. this investigation is a quality improvement project designed to elucidate the benefits of gabapentin in pain management in patients undergoing surgery of the head and neck mucosal surfaces. it will provide much needed data in an understudied population and ultimately will improve the practice of pain management, patient satisfaction and quality of care delivered in the barnes otolaryngology department.


Eligibility criteria:
inclusion criteria: * subjects undergoing definitive mucosal head and neck resection including oral cavity, oropharynx, larynx, and hypopharynx * at least one night of planned inpatient stay exclusion criteria: * incapable of giving informed consent * age less than 18 * glomerular filtration rate (gfr) less than 30 * allergy to gabapentin * baseline gabapentin or lyrica use * chronic opioid use for over six months

Keywords: oral cavity oropharynx hypopharynx and larynx
an appraisal of minimal invasive surgery for thoracic neurogenic tumour

Conditions: Neurogenic Thoracic Tumors

Summary: mediastinal neurogenic tumors are relatively rare in children. surgical resection is essential. minimal invasive surgery is more and more used in pediatric population, but his evaluation for resection of thoracic neurogenic tumors is little studied. thoracotomy has specific long terms post operative complications. when compared to thoracotomy, thoracoscopy shows less operative blood loss, shorter duration of chest tube ans length of stay. recently, the indications of thoracoscopic approach have been assessed according to the presence or absence of image-defined risk factors (idrf) at diagnosis and after preoperative chemotherapy in a monocentric retrospective study. the investigators aimed to conduct a multicentric retrospective study to assess the role of thoracoscopy in neurogenic thoracic tumours according to the presence or absence of idrf at diagnosis, the surgical complications and outcome.

mediastinal neurogenic tumors are relatively rare in children. surgical resection is usually essential in there treatment. minimal invasive surgery with video assisted thoracic surgery is more and more used in pediatric population, but his evaluation for resection of thoracic neurogenic tumors is little studied. thoracotomy has specific long terms post operative complications including scoliosis, shoulder elevation, winged scapula and asymmetric nipples. when compared to thoracotomy, thoracoscopy shows less operative blood loss, shorter duration of chest tube and length of stay. recently, the indications of thoracoscopic approach have been assessed according to the presence or absence of image-defined risk factors (idrf) at diagnosis and after preoperative chemotherapy in a monocentric retrospective study. the authors concluded that thoracoscopy could be used for all paravertebral locations without idrf except the idrf of t9-t12 location and the presence of an intraspinal component but should be avoided for perivascular locations due to tight adherences of the tumour to the vessels and hence the risk of important bleeding. the investigators aimed to conduct a multicentric retrospective study to assess the role of thoracoscopy in neurogenic thoracic tumours according to the presence or absence of idrf at diagnosis, the surgical complications and outcome.

Eligibility criteria:
inclusion criteria: all children operated for neurogenic thoracic tumors with minimal invasive surgery exclusion criteria: -

Keywords: surgery pediatric surgical resection
impact of gh measurements on ghd diagnosis

Conditions: Growth Hormone Deficiency

Summary: human growth hormone (hgh) provocation test is an essential tool to assess growth hormone deficiency in children and young adults. it is important to have a robust and reliable method to determine the hgh peak of stimulation. this work aimed to compare three common automated immunoassays for hgh measurements and to assess whether there are still result-related differences influencing clinical decision.

the investigators analysed gh provocative test of 41 young patients (median age: 12 years) from pediatric department of montpellier hospital, (26 boys and 15 girls), admitted for follow-up or for suspicion of growth hormone deficiency. serum gh of peak concentrations were compared using three automated immunoanalyses : cobas 8000 e602 (roche diagnostics), ids-isys (ids immunodiagnostic systems) and liaison xl (diasorin s.a.).

Eligibility criteria:
inclusion criteria: * age\<18 years, admitted for suspicion (short stature or growth retardation) or follow-up of ghd in pre-and pubertal age * patients undergoing insulin-induced hypoglycaemia stimulation test also called insulin tolerance test (itt) * exclusion criteria: * age \> 18 years * patients undergoing different provocation tests

Keywords: growth hormone deficiency immunoanalysis hgh provocation test diagnosis
e-visit for copd and smoking cessation

Conditions: Pulmonary Disease, Chronic Obstructive; Cigarette Smoking; Telemedicine

Summary: the goal of this work is to develop, refine, and pilot test an electronic visit (e-visit) to: 1) deliver smoking cessation treatment to adults at risk for copd and 2) to improve rates of copd early detection and accurate diagnosis. the investigators will conduct a pilot rct of the copd/smoking cessation e-visit as compared to treatment as usual (tau), with primary objective to provide effect size estimates for a larger rct.


Eligibility criteria:
inclusion criteria: * current cigarette smoker, * enrolled in musc's epic mychart program or willing to sign up for mychart, * possess a valid e-mail address that is checked daily, * english fluency, and * owner of an ios or android-compatible smartphone and a webcam-enabled device exclusion criteria: * copd on a patient's problem list within epic.
subsensory sacral nerve stimulation for irritable bowel syndrome

Conditions: Irritable Bowel Syndrome

Summary: sacral nerve stimulation (sns) has become a well-established treatment for patients with fecal incontinence since 1995. the mechanism of action of sns is still not fully understood but recent studies have shown changes in both colonic motility and rectal sensibility. we have previously shown ibs patients to benefit from sacral nerves stimulation. with the present study, we aim to evaluate if subsensory sacral nerve stimulation is as effective as suprasensory sacral nerve stimulation.

twenty four patients with ibs-d or ibs-m according to the rome iii criteria, will be enrolled in the study. having meet inclusion criteria, the patients are randomised to receive either off-subsensory or subsensory-off stimulation in a 2+2-week period followed by 2 weeks of suprasensory stimulation. hereby rendering a percutaneous nerve evaluation (pne) test of a total of 6 weeks. during the pne test the effect of the stimulation is evaluated by specific ibs symptom and quality of life questionnaires (gsrs-ibs and ibs-is) and bowel habit diaries.

Eligibility criteria:
inclusion criteria: * patients aged over 18 * patients who are psychologically stable and suitable for intervention and able to provide informed consent. * patients who are diagnosed with ibs-d or ibs-m according to the rome iii criteria * minimum average of 40 points in the symptom quistionnaire evaluated at baseline exclusion criteria: * overt bowel diseases including inflammatory bowel disease * pregnant or breast feeding * patients who are considered unable to follow the planned programme of the study, including mentally illness or physiological instability * patients who are on medication with known influence on gastrointestinal motility including those for thyroid disease, diabetes mellitus, celiac disease and neurological disease

Keywords: irritable bowel syndrome sacral nerve stimulation symptoms quality of life bowel habits
complicated rhinosinusitis

Conditions: Orbital Complications of Rhinosinusitis

Summary: rhinosinusitis is among the most common conditions encountered in the primary care clinic.

serious sequelae of ars, including orbital and intracranial complications as like periorbital oedema and displaced globe and double vision and ophthalmoplegia reduced visual acuity

Eligibility criteria:
inclusion criteria: * patients with orbital complications of rhinosinusitis exclusion criteria: * 1- previous maxillofacial trauma history. 2- previous nasal or paranasal surgery. 3- invasive fungal rhinosinusitis. 4- cases with odontogenic rhinosinusitis. 5- immotile cilia syndrome, cystic fibrosis
oscipulse device for the prevention of vte

Conditions: Venous Thromboembolism; Deep Vein Thrombosis; Pulmonary Thromboembolisms

Summary: this is a phase 2 safety and tolerability trial that will take place in two parts. part one of the trial will determine the tolerability of the oscipulse device on healthy subjects who wear the device for up to three hours. healthy volunteers will answer questionnaires and may undergo an ultrasound test at the end of their participation in the trial. part two of the trial will determine the safety and tolerability of the oscipulse device on subjects admitted to penn presbyterian medical center. eligible subjects will be enrolled for 6 hours. in the first 3 hours, subjects will wear the standard of care intermittent pneumatic compression device or the oscipulse device. in the second 3 hours, the subject's device will be switched and subjects will wear the alternate device not used in the first 3 hours. subjects will answer questionnaires and may undergo an ultrasound at the end of the first 3 hours and at the end of the second 3 hours (at hour 6).


Eligibility criteria:
inclusion criteria: part 1: adult over the age of 40, generally healthy without a current foot or ankle injury, no history of diagnosed vascular disease including dvt, pe, vte, post-phlebetic syndrome, or chronic venous insufficiency, mentally alert and understand english proficiently, able to give informed consent part 2: adult over the age of 18, admitted to the at penn presbyterian medical center, anticipated decreased level of mobility for at least 6 hours as determined by the clinical team in collaboration with study personnel, mentally alert and understand english proficiently, able to give informed consent. exclusion criteria: part 1: injury to the lower limbs, skin breaks, abrasion, or irritation in the area of the limb in contact with the oscipulse device. part 2: 1. inability or contraindication to applying ipc to both legs such as: * evidence of bone fracture in lower extremities * burns in the lower extremities, lacerations, ulcers, active skin infection or dermatitis, \& ischemic limb in the legs at the site of ipc placement * acute ischemia in the lower extremities * severe peripheral vascular disease * amputated foot or leg on one or two sides * compartment syndrome * severe lower extremity edema 2. subjects anticipated to require surgical intervention within six (6) hours of admission 3. subjects with history of vte (dvt or pe) 4. previous vascular surgery 5. pregnancy or within 6 weeks of postpartum period 6. limitation of life support, life expectancy \< 7 days or palliative care 7. admitted to an outside hospital more than 24 hours prior to screening 8. a head-unit is unavailable for the 6 hours or more 9. at the discretion of the attending physician and / or clinical team, the subject's participation in the study is believed not to be in the best interest of the subject.
sympatholysis in chronic kidney disease

Conditions: Chronic Kidney Disease

Summary: the purpose of this study is to find out why patients with chronic kidney disease (ckd) have poor exercise capacity and what causes an increase in blood pressure during exercise (i.e. increased adrenaline levels, or decreased ability of blood vessels to dilate).

patients with chronic kidney disease (ckd) suffer from exercise intolerance and poor physical capacity which contributes to increased cardiovascular risk in this patient population. prior studies have shown that ckd patients have an exaggerated increase in blood pressure (bp) during both static and rhythmic exercise. such abnormal hemodynamic responses to exercise can contribute to poor physical capacity and abnormal muscle blood flow during exercise in these patients. the goals of this project are to investigate the mechanisms and potential therapies targeting the abnormal hemodynamic response during exercise in ckd by examining the roles of impaired vasodilation, and exaggerated vasoconstriction.

Eligibility criteria:
inclusion criteria: * veterans with stages iii and iv chronic kidney disease (ckd) * kidney transplant recipients with varying degrees of kidney function * veterans 18-75 years old, without kidney disease, as study controls * exercise less than 20 minutes twice per week * willing and able to cooperate with the protocol exclusion criteria: * severe ckd (estimated glomerular filtration rate (egfr) \< 15 cc/minute) * metabolic alkalosis (serum bicarbonate \> 28 meq/l) * ongoing drug or alcohol abuse * diabetic neuropathy * any serious systemic disease that might influence survival * severe anemia with hemoglobin (hbg) level \< 10 g/dl * clinical evidence of congestive heart failure or ejection fraction below 35% * symptomatic heart disease determined by prior electrocardiogram, stress test, and/or history * treatment with central alpha agonists (clonidine) * uncontrolled hypertension with blood pressure (bp) greater than 170/100 mmhg * low blood pressure with bp less than 100/50 mmhg * pregnancy or plans to become pregnant * current treatment with monoamine oxidase inhibitors (maois) * inability to exercise on a stationary bicycle
impact of myotensives techniques, with and without auto-reeducation, on the vital capacity forced by the patient affected by a honeymoon parkinson's disease

Conditions: Parkinson Disease

Summary: lower respiratory tract infections are one of the main hospitalization or mortality cause in idiopathic parkinson's disease. because of akinesia and articular rigidity these patient develop restrictive syndrome by reduction in the thoraco-lung compliance.the consequence is a progressive loss of the aerobic physical abilities and infection. the myotensive technique of active muscular stretching seem to increase the range of motion in healthy subject but also in patient with chronic bronchiotisis . these technics also increase the vital respiratory capacity and re enforce the muscles.so adding these technics during the period when the parkinson's disease patient is stable would be a way of improvement .

to validate if these techniques really improve the the vital respiratory capacity, investigators randomize patient in 2 groups; one will have the standard protocol of stretching + self stretching of the same muscles (experimental group) and the other one (control group) will have the standard protocol and self stretching of forearm . self stretching of forearm is selected to avoid bias .

Eligibility criteria:
inclusion criteria: * age \>18 * with parkinson's disease * stable stade of pathology * without any treatment modification. exclusion criteria: * rehabilitation support or osteopathic support * active smoking * respiratory disease * cognitives trouble * any other neurologic pathology
effect of different skin creams on tewl

Conditions: Dermatitis, Atopic

Summary: prospective, single center, clinical pilot study to test the hypothesis that lipid rich epiceram® is superior in improving skin barrier function compared to aveeno daily moisturising sheer hydration lotion®.

prospective, single center, clinical pilot study to test the hypothesis that lipid rich epiceram® is superior in improving skin barrier function compared to aveeno daily moisturising sheer hydration lotion®. primary objective: to compare skin barrier function, assessed by tewl auc, between non-lesional areas of the skin treated with epiceram®, aveeno daily moisturising sheer hydration lotion® or no emollient use for one week. secondary objectives: to assess lipid and protein profiles of skin tape strips from non-lesional skin, after a week of either epiceram®, aveeno daily moisturising sheer hydration lotion® or no treatment. exploratory objectives : * to study whether the effects on tewl on lesional and non-lesional skin persist 24 hours after cessation of therapy. * to evaluate whether baseline food and environmental allergy sensitization (assessed via skin prick testing during screening) affects the outcomes. see protocol section 3.1 for allergen details. * a central repository of blood samples will be stored for future use to assess plasma biomarkers to help characterize clinical outcome data.

Eligibility criteria:
inclusion criteria: 1. parent guardian must be able to understand and provide informed consent per institutional review board (irb) guidelines and regulations. 2. male or female participants, between the ages of 0 to 40 years will be included 3. diagnosis of moderate to severe active ad (scoring atopic dermatitis (scorad) score \> 26) without a history or current manifestations of eczema herpeticum (eh) 4. ad affecting at least 3 different skin areas (contralateral arms and one lower extremity) exclusion criteria: 1. inability or unwillingness of a parent guardian to give written informed consent, or to comply with study protocol. 2. participants with skin disease other than ad that might compromise the stratum corneum barriers (e.g., bullous diseases, psoriasis, cutaneous t-cell lymphoma (also called mycosis fungoides or sezary syndrome\], dermatitis herpetiformis, hailey-hailey, or darier's disease). 3. known or suspected immunosuppression 4. severe concomitant illness(es) 5. history of serious life-threatening reaction to latex, tape, or adhesives 6. has received total body phototherapy (e.g., ultraviolet light b \[uvb\], psoralen ultraviolet light a \[puva\], tanning beds \[\>1 visit per week\]) within 30 days of the enrollment visit 7. use of topical corticosteroids, topical immunomodulatory agents (such as calcineural inhibitors and crisaborole), or topical antibiotics on the upper or lower extremities within 7 days of the enrollment visit 8. has taken a bleach bath within 7 days of the enrollment visit 9. use of systemic antibiotics, antiparasitics, antivirals, or antifungals within 7 days of the enrollment visit.

Keywords: dermatitis emollient atopic dermatitis
evaluation of pharmaceutical care in depressed outpatients

Conditions: Depression

Summary: the study examines whether pharmacotherapeutic follow-up improves outcomes of treatment of depressed outpatients.


Eligibility criteria:
inclusion criteria: * women between 18 and 65 years, with diagnostic hypothesis of depression at the beginning of treatment or change in treatment unless 2 months (dosage or substance) exclusion criteria: * record of dependence on psychoactive substances, diagnosed schizophrenia, * low education (illiterate) or cognitive impairment evident that compromise the completion of research instruments

Keywords: pharmaceutical care depression compliance pharmacist's intervention dáder
interest of intravenous ondansetron in the prevention of spinal anaesthesia-induced hypotension in caesarean section

Conditions: Hypotension

Summary: the intravenous injection of 8mg of ondansetron (a serotonin type 3 receptor antagonist) before spinal anaesthesia for caesarean section, leads to a smaller reduction in systolic arterial pressure (sap). the expected results are a decrease in the frequency and severity of hypotension, thus leading to improved comfort for the mother and decreased maternal and foetal morbidity. indeed, episodes of hypotension are responsible for impaired foeto-placental circulation, with sometimes severe consequences for neonates. it has been established that episodes of hypotension alter foetal ph. investigators therefore hope to see a smaller reduction in sap in the ondansetron group, and show a benefit for the infant. one of the objectives of this study is also to observe a decrease in the quantity of vasopressors used and thus to avoid the adverse effects of their use in high doses. the expected results are thus an improvement in haemodynamic stability during spinal anaesthesia for caesarean section. the originality of this project lies in the use of a cnap monitor (continuous non-invasive arterial pressure) as the collection of haemodynamic data will allow greater precision with the continuous measurement of ap, as well as a study of maternal cardiac output.


Eligibility criteria:
inclusion criteria: * persons who have provided written informed consent * persons with national health insurance cover * patients aged over 18 years, asa i or ii * about to undergo scheduled or non-scheduled caesarean section under spinal anaesthesia exclusion criteria: * adults under guardianship * contra indication for spinal anaesthesia (sa) (refusal, haemodynamic instability, innate or acquired coagulation disorder) * history of hypersensitivity to zophren or local anaesthetics * heart and/or kidney failure * treatment with angiotensin converting enzyme (ace) inhibitor, beta blockers, or angiotensin ii receptor antagonist (ara ii), zophren, atropine, selective serotonin reuptake inhibitors, triptans * caesarean in a context of extreme emergency, with a time to foetal extraction incompatible with sa and the injection of zophren, (up to 30 minutes) and requiring consent in an emergency. * pregnancy-related arterial hypertension (aht) * pre-eclampsia * gestational diabetes

Keywords: spinal anaesthesia