Kornimate/medical-research-clean huggingface dataset:
linearity and non-linearity of cerebral autoregulation

Conditions: Stroke, Acute

Summary: injured brain tissue supplied by a disturbed state of cerebral autoregulation (ca) is at risk of secondary ischemia, e.g. in patients with stroke, subarachnoid hemorrhage, intracerebral hemorrhage or bacterial meningitis. up to now, there is lack of a simple and easy to perform bed side test that would allow for to intervene when ca failure is indicated. for this purpose, we explore the dynamics of the interplay between blood pressure and cerebral blood flow velocity using transcranial doppler ultrasound (or near infrared spectroscopy derived haemoglobin concentration changes) as a measure of ca. to describe these dynamics different mathematical models are used, but they all still need validation and proof of concept because these dynamics are poorly understood with respect to the factors which influence the composition of the mathematical models. objectives: to what amount is ca disturbed in the different stroke subgroups ? is a disturbed ca a risk factor of poorer outcome ?

we investigate which factors determine the dynamics of ca under the assumption that disturbed dynamics of the relation blood pressure (bp) - cerebral blood flow velocity cbfv) indicate a disturbed ca. factors to be considered relevant are bp, blood carbon dioxide (co2) concentration (measured as endtidal co2 concentration), autonomic nervous system function such as heart rate, pulse pressure amplitude and baroreflex sensitivity, movement or psychological tasks, and in the patients the kind and the severity of the underlying disease. via different mathematical models the effects of these variables on cbfv as the output function is evaluated. the most frequently used approach is the use of transfer functions. in the registry will include the patients with acute strokes hospitalized at our stroke center. we will include every stroke patient with any kind and severity of stroke syndromes who gives informed consent and who has a so called temporal ultrasound window to insonate the middle cerebral artery. bp will be measure noninvasively by a finapres device. items registered are age, gender, cerebrovascular risk factors, temperature, mean bp and ist variability on days 1-3, stroke classification using toast, perfusion computed tomography and mri, and at the time of the simultaneous recordings of cbfv and bp the endtidal co2, mean bp, mean pulsatility index, and after transfer function analysis coherence, gain and phase in different frequency ranges

Eligibility criteria:
inclusion criteria: * every typ of ischemic stroke of any severity * presence of a "temporal bone window" exclusion criteria: * age \< 18 years, * pregnancy * no informed consent. * absence of a "temporal bone window"

Keywords: stroke, cerebral autoregulation, doppler, carotid disease
evaluation of the effects of immune cells on periodontal healing

Conditions: Periodontitis

Summary: periodontitis is an inflammatory disease with an infectious character, where, as the result of the host response to a dysbiotic microflora, attachment and bone loss occur. the host response and the healing period following the treatment differs among individuals, but the reason behind is not fully understood. the macrophages and t cells play an important role in the immune response and in the pathogenesis of periodontal diseases, but their role in the healing following periodontal therapy is not known. in this study, we aim to reveal the effects of initial macrophage and t cell activities in the gingival tissue on the differences of the response to phase i periodontal treatment. 42 individuals will be included in the study. granulation tissue samples will be collected from two separate deep pockets of each individual, initially. at the same session, full-mouth scaling and root debridement will be conducted. saliva, subgingival biofilm and gingival crevicular fluid (gcf) samples will also be collected, initially, and at the 2nd, 6th, 12th and 24th weeks. at the same appointments, periodontal parameters will be recorded. when the clinical procedures are concluded, the samples will be sent to turku university with dry ice. tissue and gcf concentrations of related cytokines will be analyzed with luminex. the density of macrophage types will be defined by immunoblot analysis of related markers. macrophage subpopulations in tissues will be specified by proteomics. likewise, quantities of periodontal pathogens will be evaluated with dna isolation and next generation sequencing.


Eligibility criteria:
inclusion criteria: * moderate to severe periodontitis * having at least two pockets ≥ 6 mm * systemic healthy exclusion criteria: * received periodontal treatment prior to study * received antibiotic or antiinflammatory drugs in the last 6 months * pregnant or in lactation

Keywords: periodontitis macrophages t-lymphocytes treatment outcome
a study in infants to test two preparations (freeze-dried or liquid) of the rotavirus vaccine (hrv vaccine).

Conditions: Infections, Rotavirus

Summary: the aim of this this study is to evaluate the lot-to-lot consistency of the liquid formulation of gsk biologicals' hrv vaccine and to evaluate the liquid formulation compared to the lyophilised formulation of gsk biologicals' hrv vaccine when administered concomitantly with a combination childhood vaccine.


Eligibility criteria:
inclusion criteria: * healthy infants birth weigh \>2000 g, 11 -17 weeks old at dose 1 with written informed consent. exclusion criteria: * allergic reaction to vaccine components; clinically significant history of chronic gi disease (uncorrected gi congenital malformation) or other serious medical condition per investigator, received vaccines or treatment prohibited by the protocol; immunocompromised.

Keywords: hrv vaccine diarrhoea rotavirus
early neurological assessment with pupillometry in cardiac arrest during resuscitation

Conditions: Cardiac Arrest; Out-Of-Hospital Cardiac Arrest

Summary: easy care study wants to demonstrate a correlation between intra-cpr infrared quantitative pupillometry and return of spontaneous circulation (rosc). neurological pupil index (npi) will be used alone and in association with end-tidal co2.

at the arrival of medicalised rescue team on the emergency scene, patient will be screened for including criteria. in case of eligibility pupillometry will be collected each eye in the following frame time: * t 0: time of enrolling * t 1: after first cycle of resuscitation (approximatively 2 minutes following guidelines) * t 2 ... tn: every cycle of cpr (or every 2 minutes if intubated patient) bilateral pupillometry will be collected * t end: the last pupillometry at rosc time or death. all pupillometry mesures will be obtained from a technician not trained to interpret npi index. this to maintain blindness during resuscitation efforts. data will be collected in anonymous web-based database passwords protected. for the survivors patients enrolled, data collecting continue in intensive care unit (icu) as neuroprognostication exams (biomarkers, imaging, neurophysiology). blind follow up will be obtained from icu as described in secondary outcome section

Eligibility criteria:
inclusion criteria: * not traumatic cardiac arrest in pre-hospital setting (ohca) * unexpected ohca * lombardy region territory exclusion criteria: * traumatic brain injury * cerebrovascular emergecies at computer tomography (ct) scan after hospital admission * peripheral or cortical blindness * one or both eyes loss * iris palsy or known peripheral anisocoria * no indication for resuscitation
treatment of talus fractures: a retrospective study

Conditions: Talus Fracture

Summary: the main purpose of this retrospective case series study was to evaluate long-term radiographic and clinical outcomes of a consecutive series of patients with diagnosis of isolated, displaced, closed talar neck or body fractures treated by open reduction and internal fixation. secondly, it was aimed to verify the influence of the location of talar fractures on the outcomes, the prognostic value of the hawkins sign, whether operative delays promote avascular necrosis (avn) and if the fractures require emergent surgical management.

from january 2007 to december 2012, 31 patients underwent orif by screws at our institution. on the basis of inokuchi criteria, the injuries were divided between neck and body fractures, which were classified according to hawkins and sneppen, respectively. the patients included were divided into two groups in relation to fracture location and complexity. radiographic assessment focused on reduction quality, bone healing, hawkins sign and osteoarthritis development. for clinical evaluation, clinical-functional scores (aofas ankle-hindfoot score; mfs; ffi-17; sf-36) and vas were determined, and statistical analysis was performed.

Eligibility criteria:
inclusion criteria: * diagnosis of a closed, isolated, displaced talar neck or body fracture with 2 or more millimetres displacement, subsequently treated by orif * age between 18 and 85 years * informed consent to participate. exclusion criteria: * undisplaced fractures or involvement of both the neck and the body, * open fractures, talar head and peripheral fractures including posterior process, osteochondral fractures, primary arthrodesis or amputation, * history of severe neurological deficit, * previous foot surgery or trauma, * diagnosis of rheumathological diseases or psoriatic arthritis, foot neuropathy, severe vascular insufficiency and alcohol or drug abuse.

Keywords: talar fractures talar neck fractures; talar body fractures; talus; orif; screw fixation.
functional assessment of the infart-related artery with bioactive and polymer-free coronary stents (the funcombo trial)

Conditions: Endothelial Dysfunction; Coronary Microvascular Disease; Myocardial Infarction

Summary: a total of 50 patients with st-elevation myocardial infarction (stemi) undergoing primary-percutaneous coronary intervention (ppci) will be randomized to two different coronary stents: biofreedom vs. combo stent. all patients will undergo to 6-month scheduled coronary angiography to evaluate the endothelial function response of the distal coronary segment and other functional parameters.

the bioengineered combo stent (orbus neich, fort lauderdale, florida, united states) has a dual-therapy strategy, which combines a sirolimus-eluting coating with an anti-cd34 antibody layer to promote vessel healing. sirolimus release (5 μg/mm) is completed in 30 days, and the biodegradable polymer disappears within 90 days. cd34 antibodies are immobilized on the surface of the stent and capture circulating endothelial progenitor cells (epcs). the captured epcs are triggered by sheer stress from the circulating blood and other cell signals to differentiate and mature into endothelial cells. combo plus is the only stent with a biological coating that actively repairs the vessel morphology. however, little is known regarding the endothelial function after stent implantation.

Eligibility criteria:
inclusion criteria: * stemi \< 12 hours undergoing primary pci. * st-segment elevation of \> 1mm in \> 2 contiguous leads, or (presumably new) left bundle branch block, or true posterior mi with st depression of \>1mm in \>2 contiguous anterior leads. * presence of at least one acute infarct artery target vessel with one or more de-novo coronary artery stenosis in a native coronary artery within 2.75 - 3.75 mm reference vessel diameter and \< 24 mm length (visually estimated). exclusion criteria: * inability to provide informed consent * female of childbearing potential (age \<50 years and last menstruation within the last 12 months), who did not undergo tubal ligation, ovariectomy or hysterectomy * known intolerance to aspirin, heparin, plla, everolimus, contrast material * cardiogenic shock * unprotected left main coronary artery stenosis * distal occlusion of target vessel * acute myocardial infarction secondary to stent thrombosis * mechanical complications of acute myocardial infarction * severe tortuous, calcified or angulated coronary anatomy of the study vessel that in the opinion of the investigator would result in sub-optimal imaging or excessive risk of complication in the follow-up procedure * active bleeding or coagulopathy or patients at chronic anticoagulation therapy * chronic renal dysfunction with creatinine clearance \< 45 ml/minm2 * subject is currently participating in another clinical trial that has not yet completed its primary endpoint

Keywords: endothelial function
usefulness of intraoperative ultrasound in a volar plate distal radius fixation

Conditions: Distal Radius Fracture; Ultrasound

Summary: distal radius fracture is a common injury with a high percentage of surgical treatment. in the last decades, volar plate fixation has been the treatment of choice. however, complication rates range between 6% and 50% according to the different study groups. one of the main complications is due to errors in screw measurement given the particular anatomy of the distal radius. numerous views in addition to the standard ones have been described in order to increase the specificity and sensitivity in the detection of poorly implanted screws. in the absence of a radiological projection superior to another, we believe that the use of intraoperative ultrasound can provide a non-invasive and quick revision element that avoids scope time for both: the patient and the surgical team.

patients will be recruited in a sequential mode after signing the usual informed consent (ic) as well as the consent to accept participation in the study. the intervention will be carried out as usual and, once the radiological checks have been carried out, an ultrasound of the wrist extensor compartments will be performed. compartments will be studied individually in order to detect invasion of the dorsal cortex by the screws. all surgeries will be performed only by members of the upper limb trauma team or hand surgery unit. postoperative follow-up will be the standard one prior to the present study.

Eligibility criteria:
inclusion criteria: * patients over 18 years of age * both sexes * surgical criteria distal radius fracture. * patients with sufficient understanding capacity to read and understand an informed consent. exclusion criteria: * patients with a history of any type of surgical intervention on the same limb distal to the elbow.

Keywords: distal radius volar fixation intraoperative ultrasound screw protrusion detection
early life exposures among children with sickle cell disease

Conditions: Sickle Cell Disease; Adverse Childhood Experiences; Breastfeeding

Summary: this study is being conducted to determine the relationship between early childhood exposures, such as adverse childhood experiences, social determinants of health and nutrition/breastfeeding, among children with sickle cell disease, and behavioral interventions aimed to reshape psychological resilience and lifestyle factors towards positive health outcomes.

during year 3 of the award period, 20 mother-infant dyads will be randomly assigned to either a community-based breastfeeding support group or observation. acceptability to enrollment, intervention adherence for at least 6 months and preliminary effectiveness will be captured. biomarkers of inflammation, development of asthma and incidences of pain and/or acute chest syndrome will be compared among the intervention and control groups.

Eligibility criteria:
inclusion criteria: * mother of infant with sickle cell disease * resides within the city of birmingham, alabama or in close proximity exclusion criteria: * prescribed teratogenic medications * no/limited internet access

Keywords: sickle cell disease adverse childhood experiences breastfeeding
clinical features, treatment mode and health outcomes of chest pain patients in china (change)

Conditions: Chest Pain Center; STEMI - ST Elevation Myocardial Infarction

Summary: chinese cardiovascular association is an association dedicated to establishing chest pain centers in hospitals that have basic qualifications and meet pre-designed quality control targets.the vision of chinese cardiovascular association is the cardiovascular health of every chinese, and the mission is to realize the early arrival of the inflection point of cardiovascular events in china.the institute of china heart house is responsible for the daily management and implementation of chinese cardiovascular association and the implementation and management of the chest pain center construction project.in order to improve standard treatment and chest pain system management to achieve better outcomes for patients, china heart house established the chest pain center database.the database includes patients in 4129 registered hospitals in 31 provinces in china who have been admitted with chest pain.the database can reflect the clinical characteristics, treatment and outcome of patients with chest pain in china. this non-interventional, retrospective study analyzed the chest pain center database to understand the demographics, clinical characteristics, treatment patterns and clinical outcomes of patients with chest pain, and to analyze the effects of different treatment patterns, including chest pain centers and related collaborative treatment networks.the results of the study will assess the gap between the real-world situation and the recommendations of the guidelines and reflect the effect of chest pain centers and related collaborative treatment networks on the treatment process and service quality.the research results can be directly translated into the basis of medical treatment system intervention, and also provide decision-making reference for improving the certification standards and quality control of chest pain centers.


Eligibility criteria:
inclusion criteria: * age 18 and above * patients admitted with chest pain * diagnosis is made by the treating physician based on local practice and clinical judgment exclusion criteria: * no
comparison of postoperative outcomes between surgeries anaesthetized with propofol and inhalational anaesthetics

Conditions: Acute Pain

Summary: propofol used as anaesthesia in surgery had shown small postoperative analgesic benefits over inhalational anaesthetics in some meta-analyses. it was also associated with reduced risk of postoperative nausea and vomiting. small sample of studies together with high heterogeneity prevented some meta-analyses to confirm propofol's effect for postoperative morphine consumption and other outcomes. acute pain service data bank can provide an alternative way of evaluating postoperative outcomes of propofol anaesthetics through supplying a very large sample size in a more homogeneous setting. retrospective study comparing propofol and inhalational anaesthetics on postoperative pain matched on patients' demographic and clinical data had been done for liver surgery. propofol's benefits for postoperative pain and morphine consumption was confirmed but not for adverse effects. this study plans to analyze the postoperative outcome data from an acute pain service data bank in years 2015-17 to compare the anaesthetics of propofol and inhalational anaesthetics. comprehensive regression adjustment for confounders are performed using all available patients' demographic, clinical and anaesthetic data. all major surgery types are included. results will provide postoperative outcome differences between propofol and inhalational anaesthetics for all surgeries and for specific type of surgeries. the large sample bank will provide higher probability for detecting outcome difference between the anaesthetics for all the major surgical types.

objective: to compare the postoperative outcomes between surgeries anaesthetized with propofol and inhalational anaesthetics in the acute pain service records of queen mary hospital for years 2015-17 methods: retrospective data collection 1. demographic data; 2. type of surgery; 3. type of anaesthetic techniques; 4. postoperative nrs pain scores (rest and moving) for postop days 1, 2 \& 3; 5. accumulated amount of patient controlled analgesia (pca) used in postop days 1, 2 \& 3; 6. postoperative incidence of nausea, vomitting, dizziness and pruritus.

Eligibility criteria:
inclusion criteria: 1. postoperative outcomes from acute pain service data bank between jan 2015 and dec 2017 in queen mary hospital would be retrieved; 2. surgeries with general anaesthesia by either propofol or inhalational anaesthetics. exclusion criteria: 1. essential data missed; 2. surgical types with small sample size below 30 for the data collection period.

Keywords: propofol, inhalation anaesthetics, postoperative outcomes, regression control
mifepristone and misoprostol for fetal demise

Conditions: Anembryonic Pregnancy; Gestation Abnormality; Intrauterine Fetal Demise Term

Summary: this is a pilot clinical trial to evaluate whether the medical management of early pregnancy failure with mifepristone and misoprostol is an effective and acceptable treatment. subjects with early pregnancy failure receive mifepristone followed 24 hours later by vaginal misoprostol for medical management. subjects then return on study day 3 for a repeat ultrasound to assess passage of pregnancy tissue. subjects who still have a gestational sac present at day 3 receive a second dose of vaginal misoprostol. all subjects have a follow-up at day 15, by phone for those who passed the pregnancy with the first dose of misoprostol, and in person for those who received a second dose. questionnaires are administered at the beginning and end of the study to determine acceptability.


Eligibility criteria:
inclusion criteria: healthy hemodynamically stable females with a non-viable pregnancy - exclusion criteria: * orthostatic hypotension, contraindication to either mifepristone or misoprostol, treatment during current pregnancy to provide surgical or medical evacuation of the uterus, evidence of ovarian hyperstimulation syndrome, known or suspected pelvic infection,known or suspected clotting defect or receiving anticoagulants, cardiovascular disease, current breastfeeding, pregnancy with and iud in situ, current participation in another clinical trial, prior participation in this trial, suspected or confirmed endometrial av malformation, clinical indication requiring the karyotyping of products of conception