Kornimate/medical-research-clean huggingface dataset:
improving adherence to rabies pep guideline recommendations

Conditions: Rabies; Rabies Human; Rabies Virus Infection

Summary: this quasi-experimental, quality improvement study will be conducted across the houston methodist system, including all hospital-based and freestanding emergency departments (ed). previous research identified opportunities to improve patient selection and delivery of rabies immune globulin (ig) as recommended by centers for disease control and prevention (cdc) guideline recommendations for rabies postexposure prophylaxis (pep). the purpose of this study is to develop, implement, and measure the impact of a quality improvement bundle that consists of (1) rabies pep electronic health records (ehr) enhancements, (2) education to ed staff, and (3) education to patients. adherence to quality indicators, which are based on cdc guideline recommendations, for patient selection and delivery of rabies ig for 12 months following implementation (post-implementation group) will be compared with a historical control group.

background: rabies infection can occur in humans when key elements of the rabies pep regimens are omitted or incorrectly administered. the cdc advisory committee on immunization practices (acip) recommends that patients who are exposed to rabies virus should receive prompt and thorough wound cleansing followed by administration of human rabies ig and rabies vaccine. previous research identified three opportunities to improve adherence to cdc guideline recommendations for rabies pep: (1) infiltration of rabies ig into and around the wounds, if anatomically feasible, (2) administration of rabies ig at an anatomical site distant from rabies vaccine administration, and (3) avoiding administration of rabies ig into the buttock. study design: this quasi-experimental, quality improvement study evaluates adherence to 6 quality indicators, which are based on cdc guideline recommendations, for patient selection and delivery of rabies ig before and after implementation of the rabies pep quality improvement bundle. the quality improvement bundle includes ehr enhancements, ed staff education, and patient education. patients who receive at least one dose of rabies ig or rabies vaccine at a study site during the study period will be included in this study. the historical control group includes patients treated prior to bundle implementation. the post-implementation group includes patients treated within 12 months following bundle implementation. the primary outcome is full adherence to all 6 quality indicators for rabies ig selection and delivery.

Eligibility criteria:
inclusion criteria: • receive at least one dose of rabies ig or rabies vaccine at a study site during the study period

Keywords: rabies immune globulin rabies vaccine rabies postexposure prophylaxis rabies pep rabies ig
role of a silicone prosthesis to prevent airway obstruction recurrence in lung cancers

Conditions: Lung Neoplasm; Carcinoma, Non-Small-Cell Lung

Summary: a tumoral obstruction of the main stem bronchus is frequently observed in the follow-up of lung cancers with a high impact on survival and quality of life of these patients. the endoluminal resection of these tumors through interventional bronchoscopy can remove the tumor but fails to prevent the recurrence. a stent insertion could achieve this goal but this option was never proved in a prospective protocol. the aim of this study is to analyze the impact of stent insertion on the survival without symptoms of bronchial obstruction in patients treated for their cancer with and without a first line treatment (chemo-radiotherapy or chemotherapy). the patients will be included after resection of the endoluminal symptomatic tumoral obstruction. we will test the effect of the silicone stent insertion ( from novatechr ) by comparing a stent arm (170 patients with stent insertion) with a control arm (170 patients without stent). the inclusion period will last 3 years with one year of follow-up for each patient. the one-year survival without symptomatic recurrence (proved on bronchoscopy with more than 50% of obstruction in the treated zone) will be the main endpoint. all patients without symptomatic recurrence at one year will be controlled endoscopically. survival and stent tolerance will be studied as secondary endpoints. all endoscopic events will be depicted on photographs or videos. each endoscopical situation (before and after resection, recurrence or side effects of stents) will be analyzed and registered by an independent committee of 3 international experts.


Eligibility criteria:
inclusion criteria: * \> 18 years * non-small cell lung cancer, * inoperable and location : tracheal, carinal, main bronchus right or left, or intermediate trunk. * tnm stage known and oncological treatment later determined * central initial intrinsic bronchial obstruction \> 50%. * resection of tumor with endoscopy, to obtain after therapeutic bronchoscopy a diameter \> 50% normal diameter of bronchial segment achieved. * tumoral segment fully recoverable by a stent * written consent, free and informed * patient affiliated or who is entitled to to a social security scheme. exclusion criteria: * against-indication for general anesthesia. * patient with one lung not working beyond the stenosis * patient under guardianship * pregnancy * 12 months follow-up impossible

Keywords: tumoral obstruction of the main stem bronchus bronchoscopy silicone stent
the comparison of the necessity of repeat myocardial perfusion spect studies between tc-99m tetro and tc-99m mibi

Conditions: Myocardial Ischemia

Summary: research questions: 1. is there a significant difference between the causal repeat rate of myocardial perfusion studies for tc99m tetrofosmin and tc99m sestamibi? 2. is there a significant difference in the causal repeat rate of myocardial perfusion studies for tc99m tetrofosmin and tc99m sestamibi if an independent technologist reviewer blinded to the radiopharmaceutical makes the decision to repeat the study? 3. is there a significant difference in the quantitative diagnostic measures reported between the original and the acceptable repeated studies?

there are two commonly used tc-99m based radiopharmaceuticals useful in the diagnosis and localization of regions of reversible myocardial ischemia in the presence or absence of infarction under exercise and rest conditions. one is tc-99m tetrofosmin (tc-99m-1,2-bis\[bis(2-ethoxyethyl) phosphino\] ethane), the other is tc-99m sestamibi (tc-99m- methoxyisobutylisonitrile). when performing a myocardial perfusion spect (mps) study, extracardiac subdiaphragmatic activity adjacent to the myocardium can cause artifacts in the inferior wall and can be detrimental to the accuracy of the study1,2. following acquisition, mps studies are routinely checked for potential imaging artifacts. when a separation between the extracardiac activity cannot clearly be distinguished from the myocardium, the study should be repeated. repeating the spect study can affect the efficiency of a lab as well as having a negative influence on patient comfort and overall satisfaction. the goal of this study is to determine if there is a significant difference in the number of studies that should be repeated between the two commonly used radiopharmaceuticals.

Eligibility criteria:
inclusion criteria: * patients receiving sestamibi mpi study or tetrofosmin mpi study exclusion criteria: * thallium or dual isotope mpi study

Keywords: myocardial perfusion imaging repeat studies tetrofosmin sestamibi
effects of home-based neurostimulation associated with motor training in chronic stroke patients

Conditions: Stroke

Summary: objective: to investigate effects of home-based somatosensory stimulation associated with motor training on improvement in performance of the paretic upper extremity in patients in the chronic phase after stroke.

design: double-blind, randomized, controlled clinical trial. setting: home-based rehabilitation. subjects: patients in the chronic phase (\> 6 months) after stroke. interventions: patients will be randomized to an active and a control group. in both groups, treatments will be performed at home, daily, over four weeks. patients in the active group will be instructed to use a device that provides somatosensory stimulation in the form of electrical stimulation of the median nerve for two hours. patients in the control group will also be instructed to use the device for two hours, and sham stimulation will be administered. in both groups, patients will be instructed to train activities with the paretic hand immediately after nerve stimulation. main measures: the primary outcome will be improvement in performance of the paretic hand evaluated by the jebsen-taylor test at end of treatment and four months after end of treatment, compared to baseline. secondary outcomes were: 1) compliance with the interventions, assessed through a daily written log, and oral reports of the patients; 2) safety profile of the interventions.

Eligibility criteria:
inclusion criteria: * age 18-80 years; * single ischemic or hemorrhagic stroke in a cerebral hemisphere, documented by computed tomography (ct) or magnetic resonance imaging (mri); * stroke onset at least six months before; * hand paresis with preserved ability to perform all tasks of the jebsen-taylor test (jtt). exclusion criteria: * previous strokes; * epilepsy and other neurological conditions; * proprioceptive or tactile anesthesia; * shoulder or hand pain; * severe joint deformity; * severe chronic disease; * inability to give provide informed consent due to severe aphasia or cognitive impairment; * left handedness before the stroke.
to explore the safety and efficacy of intravenous infusion of different doses of lidocaine in patients

Conditions: Liver Cancer

Summary: all patients who met the inclusion criteria were randomly divided into four groups, 30 cases in each group, which were lidocaine group 1, lidocaine group 1.5, lidocaine group 2, and the placebo group in lidocaine group 1, lidocaine group 1.5, and lidocaine group 2, 1% lidocaine 1.5 mg/kg was intravenously infused with a micropump after anesthesia induction, and the infusion was completed within 10 minutes according to the ideal body weight, and then continued for 1% lidocaine was infused at 1 mg/kg.h, 1.5 mg/kg.h and 2 mg/kg.h respectively until the end of the operation. in the placebo group, the same volume of normal saline was used instead.

all patients who met the inclusion criteria were randomly divided into four groups, 30 cases in each group, which were lidocaine group 1, lidocaine group 1.5, lidocaine group 2, and the placebo group in lidocaine group 1, lidocaine group 1.5, and lidocaine group 2, 1% lidocaine 1.5 mg/kg was intravenously infused with a micropump after anesthesia induction, and the infusion was completed within 10 minutes according to the ideal body weight, and then continued for 1% lidocaine was infused at 1 mg/kg.h, 1.5 mg/kg.h and 2 mg/kg.h respectively until the end of the operation. in the placebo group, the same volume of normal saline was used instead.postoperative pain management during the first 72 postoperative hours will involve the use of a pcia device, which will contain lidocaine 30mg/kg, sufentanil 2 μg/kg, granisetron 12 mg diluted to 200 ml in 0.9 % normal saline. in the placebo group, the same volume of normal saline will be administered during anesthesia. the postoperative pcia device will contain sufentanil 2 μg/kg, granisetron 12 mg diluted to 200 ml in 0.9% normal saline solution with a total volume of 200 ml. all the background infusions of pcia will set at 2 ml/h, the bolus volume of each pcia press is 2 ml and the lockout interval is 15 min.

Eligibility criteria:
inclusion criteria: * age: 18-70 years old * american society of anesthesiologists(asa) ⅰ～iii * bmi≤30 * intended for open liver resection exclusion criteria：1. long-term opioid users 2. patients with contraindications or allergies to any drugs (lidocaine, etc.) used in this study 3. patients with severe hepatic insufficiency before surgery (defined as total bilirubin\>1.46mg/dl), renal insufficiency (glomerular filtration rate \<30ml/min/1.73m2 or end-stage renal disease) 4. associated with severe heart disease (second or third degree atrioventricular block); severe heart failure (ejection fraction \<50%); sinus bradycardia; patient 6. patients who participated in other clinical trials within 3 months before enrollment in the study.
variation in anisotropy of the spinal cord in patients with hyperkyphosis

Conditions: Hyperkyphosis

Summary: spinal cord compression is commonly seen in patients with severe kyphosis. however, conventional morphologic magnetic resonance imaging (mri) was unable to detect the damage in microstructural integrity of the spinal cord around the apical vertebrae in these patients. the aim of the study was to evaluate the neuronal metrics/microstructure of the spinal cord around apical region in patients with hyperkyphosis using diffusion tensor imaging (dti).

spinal cord compression is commonly seen in patients with severe kyphosis. however, conventional morphologic magnetic resonance imaging (mri) was unable to detect the damage in microstructural integrity of the spinal cord around the apical vertebrae in these patients. the aim of the study was to evaluate the neuronal metrics/microstructure of the spinal cord around apical region in patients with hyperkyphosis using diffusion tensor imaging (dti). twenty-four patients with hyperkyphosis aged 46.1±22.8 years who underwent 3.0t mri examination with dti sequence were prospectively enrolled from july 2022 to january 2023. patients were divided into three groups according to spinal cord/cerebrospinal fluid architecture (csf) on sagittal-t2 mri of the thoracic apex: type a-circular cord with visible csf, type b-circular cord but no visible csf at apical dorsal, and type c-spinal cord deformed without intervening csf. the fractional anisotropy (fa) values acquired from dti were compared among different groups. correlations between dti parameters and global kyphosis (gk)/sagittal deformity angular ratio (sdar) were evaluated using pearson correlation coefficients.

Eligibility criteria:
inclusion criteria: * diagnosis of hyperkyphosis; * the apex located at the thoracal region (t1-t12); * full dti data; * records of detailed and systematic neurological physical examination. exclusion criteria: * any case with active infection, tumor, or trauma; * any cases of comorbidity of neurofibromatosis type i; * any cases combined with spinal syringomyelia, split cord malformations or diastematomyelia, tethered cord syndrome; * previous spinal surgery.
pap systems internal clinical studies (ics)

Conditions: Obstructive Sleep Apnea

Summary: this is a pre-market study for ongoing product development aiming to explore the usability and performance of the study pap systems to guide product development.

this is an open label, prospective, randomized cross over (or single arm) study designed to support the development of new accessories for pap devices. this generic protocol provides a framework methodology for how these ongoing studies will be conducted. this protocol then is used in a number of smaller sub-studies, each of which will have their own sub-protocol outlining the exact specifics of the study. the studies could be run face-to-face or remotely. participants are healthy volunteers who are resmed employees. recruitment will be done via emails. participants will be explained the details of the trial and those who wish to take part will be invited to a selected site for the first study visit. visit 1: participants will provide written informed consent. participants will be shown the pap systems and trial them for fit and comfort. participants may be asked initial questions on their first thoughts on the pap systems. if the participant and assessor are happy to proceed, the participants will use the loan pap system for trial. visit 2: after trialing the pap systems, participants will be asked to complete a questionnaire regarding the appeal, comfort, and usability of the pap system(s). depending on sub-study protocol, participants will then take the second pap system home to test. visit 3: the participant will return the loan pap system to the assessor. the participants' questionnaire responses will be reviewed. this concludes the participation in the study.

Eligibility criteria:
inclusion criteria: * participants who are employees of resmed * participants shall be volunteers * participants willing to give written informed consent * participants who ≥ 18 years of age * participants willing and able to complete the specified tasks exclusion criteria: * participants who are or may be pregnant. * participants with a preexisting lung disease/ condition that would predispose them to pneumothorax (for example: copd, lung cancer; fibrosis of the lungs; recent (\< 2years) case of pneumonia or lung infection; lung injury. * participants believed to be unsuitable for inclusion by the researcher. * participants who or whose bed partner has implantable medical devices which may contraindicate against masks with magnetic clips (exclusion criteria for study masks with magnetic clips only)
comparison between different ways for using lidocaine during fb

Conditions: Lidocaine Spray; Nebulized Lidocaine; Lung Diseases; Lung Cancer

Summary: compare the efficacy and safety of nebulized lidocaine, oropharyngeal lidocaine spray, or their combination for better outcome of topical anesthesia in subjects undergoing diagnostic fb; severity of cough , pain during procedure , cumulative dose of anesthesia needed and its adverse reaction , overall satisfaction .

flexible bronchoscopy (fb) is a commonly performed procedure in the diagnosis and treatment of several respiratory disease. although fb is generally a short procedure, it is uncomfortable for the patient. at least the use of topical anesthesia during fb is essential, especially when performed without sedation. effective topical anesthesia blunts airway reflexes such as gag, cough, and laryngospasm. the reduction in cough not only improves patient comfort but also makes the procedure easier for the operator. among agents used for topical anesthesia, lidocaine is the most widely used drug because of its safety and favorable pharmacokinetic profile. lidocaine is available in various formulations (gel or solution) and can be delivered to the respiratory passages by using different modes (spray, nebulization, transtracheal injection, bronchoscope instillation, and others). in this study, will compare the efficacy and safety of nebulized lidocaine, oropharyngeal lidocaine spray, or their combination for topical anesthesia in subjects undergoing diagnostic fb, for better outcome.

Eligibility criteria:
inclusion criteria: * patients above 18 years old will undergo fb are included in this study. exclusion criteria: * known hypersensitivity to lidocaine. * pregnancy. * hemodynamic instability. * failure to provide informed consent.

Keywords: flexible bronchoscopy
anti-argonaute antibodies for the diagnosis of sensory neuronopathies

Conditions: Autoimmune Diseases

Summary: argonaute (ago) proteins have been described as the target of antibodies in several autoimmune diseases including sjögren syndrome (ss). sensory neuronopathies (snn) are disorders affecting neurons in the dorsal root ganglia that may depend on an inflammatory process. however, identifying these cases needs the availability of specific biomarkers. the aim of this study is to test the prevalence of anti-ago antibodies in a population of patients with sensory neuronopathies (snn) with and without associated autoimmune disease in comparison with other peripheral neuropathies to determine how anti-ago antibodies may help the identification of potentially dysimmune sensory neuronopathies (snn).

sensory neuronopathies (snn) are rare and debilitating diseases that fall under several etiologies. among them, dysimmune forms are the most frequent but very difficult to identify when they do not occur in the context of associated systemic dysimmune disease (sjögren syndrome (ss) syndrome) because only a biopsy of the epiphytically unthinkable posterior spinal node would support the diagnosis. it is therefore necessary to have diagnostic biological markers of these forms to consider rapid treatment before irreversible neuronal degeneration.using a protein-array technique, it has been showed that anti-fgfr3 antibodies was one of these markers and that it was associated with a clinical picture that differentiated from sensory neuronopathies (snn) without this antibody. protein-array also allowed to identify another potentially interesting antibody for the diagnosis of sensitive neuronopathies (nns). this antibody recognizes the ago1 protein. anti-ago1 antibodies have been described in association with system autoimmune diseases and in particular lupus but not in neurological diseases and more particularly in sensory neuronopathies (snn). the study want to validate the diagnostic interest of these antibodies by testing the collection of serums performed for studies on the anti-fgfr3 antibody and including patients with sensory neuronopathies (snn) and as controls of patients with another form of neuropathy and subjects with systemic autoimmune disease without peripheral neuropathy.

Eligibility criteria:
inclusion criteria: * patients with sensory neuropathy exclusion criteria: * patient not tested for anti-ago antibody

Keywords: sensory neuronopathy sensory ganglionopathy auto-antibody anti-ago antibody
acupuncture with manual and electrical stimulation to reduce labour pain

Conditions: Labour Pain

Summary: the purpose of this study is to evaluate the effect of manual acupuncture and electro-acupuncture on labour pain.

acupuncture is used in obstetric care in spite of insufficient evidence of its potential to reduce labour pain. the findings so far are contradictory, which may reflect methodological limitations. the present study will take issues into account, such as sufficiently large sample to allow detection of possible differences between study groups; optimal timing of the intervention; controlling for intensity of the treatment; qualified training of persons giving the treatment; biological markers of pain and stress; possible effects on mother and infant; women's experiences such as overall birth experience and memory of pain.

Eligibility criteria:
inclusion criteria: * admission to the labour ward in spontaneous onset of labour * latent or active phase of labour * nulliparity * singleton pregnancy, cephalic presentation * gestation: 37+0 to 41+6 (weeks + days) * expressed need for labour pain relief * swedish speaking (well enough to understand written and oral instructions) exclusion criteria: * no pharmacological pain relief within 24 hours prior to inclusion into the study * severe preeclampsia * treatment with oxytocin at the time point of allocation * treatment with anticoagulant * pacemaker

Keywords: acupuncture labour pain pain relief complementary
a bioequivalence study of serum free avonex and serum containing avonex in healthy volunteers

Conditions: Multiple Sclerosis

Summary: demonstrate the bioequivalence of a serum-free solution to a serum containing solution of avonex.


Eligibility criteria:
inclusion criteria: * healthy volunteers exclusion criteria: * history of severe allergic or anaphylactic reactions * history of hypersensitivity to acetaminophen (paracetamol), ibuprofen, or codeine. * known allergy to dry natural rubber * history of seizure disorder or unexplained blackouts * history of any clinically significant (as determined by the investigator) cardiac, endocrinologic, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, neurologic, dermatologic, psychiatric, renal, and/or other major disease other inclusion and exclusion criteria apply as per protocol

Keywords: multiple sclerosis interferon beta-1a