Kornimate/medical-research-clean huggingface dataset:
new, previously unknown, uses of optical coherence tomography angiography (octa)

Conditions: Sickle Cell Retinopathy

Summary: sickle cell maculopathy was sparingly mentioned in the literature before despite the fact that sickle cell disease or sickle cell trait is common in people of many areas of the world. this study shows that octa is a very valuable, non invasive, office procedure that may well be used in diagnosing this disease.

this is a clinical study of two african canadian patients that were diagnosed with sickle cell trait. i used octa to show macular vascular occlusions that usually happen with this disease.

Eligibility criteria:
inclusion criteria: people with sickle cell trait or sickle cell disease - exclusion criteria: -
hemodynamic effects of bolus of ketamine versus fentanyl in patients with septic shock

Conditions: Ketamine; Fentanyl; Septic Shock

Summary: ketamine is a commonly used drug for sedation and induction of anesthesia in patients with shock and/or cardiac dysfunction. ketamine is characterized by its cardiovascular stimulatory effect due to increase release of endogenous catecholamines. on the other hand, laboratory data on the isolated human myofibers suggest that ketamine had a direct myocardial depressive effect; accordingly, many experts believe that ketamine might have a negative hemodynamic effect in catecholamine depleted patients such as critically ill patients. in critically ill patients, there are contradicting results for the effect of ketamine on the hemodynamic profile and there is paucity of clinical data about the effect of ketamine on cardiac contractility and cardiac output (co). cardiac output is the primary determinant of global oxygen delivery to organs and maintaining stable co in critically ill patients is at most importance to avoid further organ damage in such patients. therefore, this study is designed to evaluate the effect a single bolus of ketamine on co in patients with septic shock in comparison to fentanyl bolus.

patients meeting the inclusion criteria will receive the study drug according to the randomization, if a bolus of sedation is required for resuming sedation after sedation vacation. all patients will be monitored by 5-lead electrocardiogram, pulse oximetry, and noninvasive blood pressure. hypotension defined as mean arterial pressure \< 65 mmhg and will be managed by increasing the norepinephrine infusion rate by 20%. bedside echocardiography will be used to measure the cardiac output by an experienced physician who is not aware of the nature of the study drug. the left ventricular outflow diameter (lvot) will be measured in the parasternal long-axis view. then velocity time integral (vti) will be measured from the apical five-chamber view. the average of three vti readings will be calculated. the cardiac output will be calculated by the equation: co = π x (lvot diameter/2) x vti x heart rate delta co% will be calculated as percentage of change at each time point in relation to the baseline measurement the co, heart rate, mean blood pressure will be measured before drug administration and at 3, 6, 10 and 15 min after drug administration

Eligibility criteria:
inclusion criteria: * adult (\>18 years) patients. * with septic shock on vasopressor therapy * mechanically ventilated * need for sedation exclusion criteria: * hemodynamic instability (map \<65 mmhg) despite appropriate volume replacement and vasopressor therapy * noradrenaline infusion rate \<0.05 mcg/kg/min * poor cardiac window on the ultrasound. * known allergy to study drugs * neurocritical patients with signs of increased intracranial tension
atricure bipolar radiofrequency ablation of persistent atrial fibrillation

Conditions: Atrial Fibrillation

Summary: ablate persistent is a prospective, non-randomized multi-center clinical trial to demonstrate the safety and effectiveness of the atricure bipolar system for treating persistent atrial fibrillation during concomitant on-pump cardiac surgery.


Eligibility criteria:
inclusion criteria: 1. subject is greater than or equal to 18 years of age 2. subject has history of persistent atrial fibrillation as defined by the acc/aha/esc guidelines 3. subject is scheduled to undergo elective on-pump cardiac surgical procedure(s) for one or more of the following: * mitral valve repair or replacement * aortic valve repair or replacement * tricuspid valve repair or replacement * coronary artery bypass procedures 4. subject's left ventricular ejection fraction ≥ 30% 5. subject is able and willing to provide written informed consent and comply with study requirements 6. subject has life expectancy of at least 1 year exclusion criteria: 1. patients with longstanding and continuous af in which cardioversion has failed or has not been attempted 2. previous cardiac ablation including catheter ablation, av-nodal ablation, or surgical maze procedure 3. wolff-parkinson-white syndrome 4. prior cardiac surgery (redo) 5. class iv nyha heart failure symptoms 6. prior history of cerebrovascular accidents within 6 months or at any time if there is residual neurological deficit 7. documented mi within 6 weeks prior to study enrollment 8. need for emergent cardiac surgery (i.e. cardiogenic shock) 9. known carotid artery stenosis greater than 80% 10. la size greater than or equal to 8 cm 11. current diagnosis of active systemic infection 12. severe peripheral arterial occlusive disease defined as claudication with minimal exertion 13. pregnancy or desire to get pregnant within 12-months of the study enrollment 14. preoperative need for an intra-aortic balloon pump or intravenous inotropes 15. renal failure requiring dialysis or hepatic failure 16. requires anti-arrhythmic drug therapy for the treatment of a ventricular arrhythmia 17. therapy resulting in compromised tissue integrity including: thoracic radiation, chemotherapy, long term treatment with oral or injected steroids, or known connective tissue disorders
carbohydrate intolerance questionnaire study

Conditions: Carbohydrate Intolerance

Summary: the purpose of this study is to evaluate the validity of using a carbohydrate intolerance questionnaire (ciq) and/or other health markers as a means of predicting response to insulin sensitivity as determined by an oral glucose tolerance test (ogtt).

this study will utilize a carbohydrate intolerance questionnaire (ciq). responses to a ciq will be correlated with diet inventories, baseline body composition and health assessments, a standard metabolic panel, fasting glucose and insulin levels, a homeostatic insulin resistance model (homa), a two hour oral glucose tolerance test (ogtt), and a carbohydrate sensitivity symptom questionnaire administered during the ogtt.

Eligibility criteria:
inclusion criteria: * participant is female * participant is between the ages of 18 and 60 exclusion criteria: * participant is pregnant or nursing * participant is diabetic or pre-diabetic * participant has a body mass index (bmi) \< 22
goal directed hemodynamic management of acute heart failure after cardiac surgery in children

Conditions: Cardiac Surgery

Summary: goal directed therapy (gdt) utilises various monitoring techniques to assess cardiovascular performance and allows for timely interventions based on predetermined algorithms. the aim of this prospective randomised study is to evaluate the effect of gdt on major complications in children undergoing radical correction of congenital heart defects, complicated by acute heart failure. goal directed therapy will be implemented with the aid of transpulmonary thermodilution and based on predetermined algorithms.


Eligibility criteria:
inclusion criteria: * informed written consent signed by legal representative (parent or guardian) * radical correction of congenital heart defect(s) * use of cardiopulmonary bypass * vasoactive-inotropic score of 10 or greater during first 24 hours after surgery. exclusion criteria: * confirmed intranatal infection; * gestational age \< 37 weeks; * inotropic support prior to surgery; * acute renal or hepatic failure prior to surgery; * participation in conflicting randomised controlled studies.

Keywords: congenital heart defect cardiopulmonary bypass goal directed therapy acute heart failure
impact of regional anesthesia on blood pressure in humeral fracture surgery

Conditions: Proximal Humeral Fracture

Summary: this study aims to compare the hemodynamic impact of two anaesthetic strategies : regional anesthesia versus general anesthesia in proximal humeral fracture surgery.

proximal humeral fracture surgery is frequently performed under general anesthesia (ga). ga is frequently associated with a high risk of hypotension with significant consequences. regional anesthesia could be an interesting alternative to ga in order to limit hemodynamic consequences, especially in elderly patients. furthermore, in the current state of covid 19 crisis, regional anesthesia could provide solutions in exposing less medical staff on patient's airway. the investigators hypothesize that the use of regional anesthesia reduces the use of intraoperative vasopressor during surgery. after ethical committee approval, a retrospective cohort of patients with proximal humeral fracture, in montpellier's university hospital, was analyzed from 2016 to 2020. an informational note was given to all patients participating to the study.

Eligibility criteria:
inclusion criteria: * asa i - iv * proximal humeral fracture * operated between january 2016 and december 2020 * emergency surgery exclusion criteria: * surgical revision or surgery for pre-existing infection, tumour * intubated patient / unconscious patient * haemostasis disorder * haemostasis disorder * refusal of the patient

Keywords: surgery general anesthesia regional anesthesia hypotension
a phase 2 study of atacicept in subjects with relapsing multiple sclerosis (atams)

Conditions: Relapsing Multiple Sclerosis

Summary: to evaluate the safety and tolerability of atacicept and to explore if atacicept reduces central nervous system inflammation in subjects with relapsing multiple sclerosis (rms) as assessed by frequent magnetic resonance imaging (mri). this study is randomised. study medication is administered via subcutaneous (under the skin) injections.


Eligibility criteria:
inclusion criteria: - diagnosis of rms (as per mcdonald criteria, 2005) other protocol-defined inclusion criteria could apply. exclusion criteria: * have primary progressive multiple sclerosis (ms) * have secondary progressive ms without superimposed relapses * relevant cardiac, hepatic and renal diseases as specified in the protocol * pretreatment with immunosuppressants and immunomodulating drugs as specified in the protocol * clinical significant abnormalities in blood cell counts and immunoglobulin levels as specified in the protocol * clinical significant acute or chronic infections as specified in the protocol other protocol-defined exclusion criteria could apply.

Keywords: relapsing multiple sclerosis atacicept
effect of a fatty meal on endoscopic retrograde cholangiopancreatography (ercp)

Conditions: Biliary Tract Disease

Summary: this study is to determine if a fatty meal would improve the ercp procedure.

a fatty meal is a potent stimulator of cholecystikinin (cck) in human body. the biological effect of cck is increasing bile secretion and relaxing the sphincter of oddi. theoretically, a fatty meal should facilitate the effect on cannulation at ercp. if a fatty meal can make the major papilla cannulation easier, it may significantly shorten the procedure time for ercp and even decrease complications of the procedure, since the complication rate of post-ercp is positively related to the time of the procedure. comparison: approximately one hour before ercp procedure, patient will have a fatty meal in the study group and normal saline in control group.

Eligibility criteria:
inclusion criteria: * patients, 18 years and older, who are scheduled for ercp at emory university hospital and signed consent before the procedure. exclusion criteria: * patients with a known allergy to milk or those who choose not to sign the consent.

Keywords: a fatty meal ercp
analgesic use and effectiveness for dental procedures

Conditions: Pain

Summary: opioid analgesics prescribed by dentists may contribute to the larger national issue of the use and abuse of the drug. on occasion dental pain may be sufficiently severe to support the use of opioids. this study used both dentist and patient input to evaluate the use of opioid and over-the-counter analgesics following one of seven coded common dental procedures. the study includes a five day patient follow up assessment of the effectiveness of the analgesic. baseline questionnaires were completed by eligible participants, and they responded to the day 5 follow up questionnaires.

specific aims the overall objective of the proposed study is to determine (1) the pattern of analgesic prescriptions (rx and otc) and recommendations (otc) in dental practices; and (2) the effectiveness of and side effects associated with these medications as measured by patientreported outcomes (pros). specific aim 1: to document (a) dentists' postprocedural prescriptions and recommendations for analgesic medication: and (b) the effectiveness of these medications and side effects associated with their use as measured by pros. specific aim 2: to analyze by procedure class and anticipated pain severity the pros of rx and otc analgesic medications. specific aim 3: determine the incidence of analgesic side effects of rx and otc analgesic medications. the outcomes of specific aims 1-3 will be: * the distribution of dentists' rx/otc prescriptions/recommendations by dentists for anticipated pain severity. * the effectiveness of different types of rx and otc analgesics (e.g., rx nsaids vs. otc nsaids, rx nsaids vs. rx narcotics) by procedure class and anticipated pain severity. * the incidence of analgesic side effects for rx and otc analgesics. analysis of the results and methods of the proposed research will furthermore serve as guidance in designing a randomized pbrn clinical trial comparing the efficacy of and complications associated with two or more analgesics.

Eligibility criteria:
inclusion criteria: 1. presence of erupted second molar teeth. 2. scheduled for treatment in one procedure of the following six procedure classes: extraction, endodontic therapy, pulp capping, crown preparation, periodontal surgery, abscess treatment 3. expected by the p-i to experience postoperative pain sufficient to require an analgesic 4. permanent dentition (erupted 2nd molar teeth) 5. capacity to judge pain level 6. ability and willingness to give verbal consent exclusion criteria: 1. under treatment for medical disorders, including dementia, parkinson's disease, depression, severe anxiety, or any other medical condition, that, in the opinion of the p-i, would affect the subject's judgment of postoperative pain 2. current participation in another dental or medical research study.

Keywords: prescribing effectiveness dental opioid analgesic
stereotactic hypofractionated radiosurgery for early stage prostate cancer

Conditions: Prostate Cancer

Summary: the purpose of this trial is to evaluate a short course of very focused (stereotactic) external beam radiation therapy for the treatment of early stage prostate cancer. the investigators will gather scientific information about the tolerance and side effects this type of radiation. the investigators will then compare these results with those of standard 8 week course of external beam radiation therapy to see if this study treatment is equally or more effective in treating prostate cancer.


Eligibility criteria:
inclusion criteria: * histologically confirmed adenocarcinoma of the prostate * gleason score ≤ 6 and low volume gleason 7 (3+4) * psa \< 10 * clinical stage of t2a or less * ability to understand and the willingness to sign a written informed consent document exclusion criteria: * prior radiation treatment for prostate cancer * gleason score \> 7 * psa \> 10 * clinical stage of t2b or greater

Keywords: prostate cancer cancer of the prostate prostate tumor novalis tx novalis stereotactic radiosurgery radiosurgery radiation
standard carbon dioxide gas versus heated humidified gas in gynaecological laparoscopy

Conditions: Heated Humidified Carbon Dioxide in Gynaecological Laparoscopic Surgery

Summary: to establish if heated humidified carbon dioxide gas improves pain scores as well as nausea and analgesic requirements in post operative patients compared to standard cold carbon dioxide.


Eligibility criteria:
inclusion criteria: * patients over 18 years of age * patients planned to undergo laparoscopy for minor procedures such as endometriosis, adhesions, ovarian cystectomies, bilateral salpingoophorectomy, tubal ligation and sterilisation will be invited to participate in the trial. * capacity to consent exclusion criteria: * patients unable to speak english * patients unable to give consent
premedication by midazolam for emergency surgery

Conditions: Anxiety

Summary: preoperative anxiety is a subjective and painful experience and may have adverse psychological consequences and complicate anesthetic management. the aim of the study is to show the effect of premedication by midazolam on preoperative anxiety assessed by a visual analog scale and by measuring salivary cortisol levels. this study was a monocentric, prospective, blind randomized placebo controlled clinical study. sixty patients, aged 18 to 79 years, to undergo elective surgery under general anesthesia with tracheal intubation must be enrolled and randomized to receive midazolam (0.02mg/kg) or placebo. the primary outcome is the reduction in anxiety assessed by a visual analog scale. the secondary outcomes are the reduction in salivary cortisol levels, the overall level of anxiety and the evaluation of respiratory and hemodynamic adverse effects of midazolam.


Eligibility criteria:
inclusion criteria: * major patient undergoing elective surgery under general anesthesia with tracheal intubation * anesthesia state 1 and 2 * preoperative fasting for 6 hours * information and signed consent * social security * non pregnant women exclusion criteria: * anesthesia state above 3 * midazolam sensibility * pregnant or breastfeeding women * icu patients * no consent * pediatric surgery * no social security * no tracheal intubation * required premedication in placebo group or midazolam sensibility in premedication group

Keywords: premedication preoperative anxiety salivary cortisol level anxiety visual analog scale
markers of oxidative stress present in left atrial appendage tissue in patients with atrial fibrillation

Conditions: Atrial Fibrillation; Atrial Flutter; Inflammation

Summary: the purpose of the study is to look at the differences between people who have irregular heart beats coming from the upper chamber of the heart (atrial fibrillation) compared to those who do not have these irregular beats.

atrial fibrillation is an abnormal heart beat that starts in the upper parts of the heart and can cause stroke or death, if untreated. in general, treatments are not very effective with frequent relapses of the abnormal heart beats. one explanation for the high relapse rate is that the treatments might not address the underlying cause of atrial fibrillation. recently, we have found that atrial fibrillation is associated with increased oxidative stress in a particular part of the top parts of the heart, the left atrial appendage (laa). oxidative stress is a condition where abnormal oxygen forms are produced. these forms harm the cells of the heart, causing them to beat abnormally. also, the inside of the heart becomes sticky and more likely to form blood clots. these clots, when they travel to the head, are thought to be the main cause of strokes in this condition. we have found increased oxidative stress and increased evidence of blood clotting in pig and mouse models of atrial fibrillation. we would like to see if these same findings are present in the human laa. in this study, we will compare blood and tissue markers of oxidative stress between patients with and without atrial fibrillation who are scheduled to undergo cardiac surgery. it is the expectation that participants with atrial fibrillation will have more abnormal markers of atrial fibrillation. this study requires participants to be seen during their routine preoperative visit, undergo a history and physical examination, give blood only once, and allow use of their discarded laa. this tissue is routinely removed at surgery because its removal is thought to reduce the risk of strokes in patients who develop atrial fibrillation after the surgery. this happens in up to 50% of patients, thus providing the desire to remove the laa.

Eligibility criteria:
inclusion criteria: * cases must have atrial fibrillation documented on electrocardiographic recordings at the time of enrollment exclusion criteria: * younger than 18 and older than 65 years of age.

Keywords: atrial fibrillation oxidative stress atrial flutter
clinical trial for assessment of safety and efficacy of a echinacea/sage spray compared to a chlorhexidine/lidocaine spray in the treatment of acute sore throats

Conditions: Pharyngitis

Summary: the aim of the study is to show non-inferiority of an echinacea/sage spray compared to a chlorhexidine/lidocaine-spray in the treatment of acute sore throat during five days of treatment. main outcome parameter is the non-inferiority in number of responders between the two treatment groups. a responder is defined as a reduction by 50% of the total baseline score taken prior to treatment start. the symptoms are assessed with a symptom score.

further secondary parameters are : responders during at day 4 and 5, single symptom scores during 1 to 5 days of observation, pain at begin and end (100mm vas), assessment of efficacy by physician and patient, consumption of rescue medication assessment of safety by physician and patient, frequency of adverse events

Eligibility criteria:
inclusion criteria: * age \> 12 years; * acute pharyngitis or tonsillitis with symptoms of throat pain and inflammation of the pharynx and/or tonsils; * onset of sore throat less than 72 hours before inclusion ; * a tonsillopharyngitis severity score ≥6; * written informed consent. exclusion criteria: * analgesics \<12 hours; * antibiotics \<24 hours; t * topical throat pain medication \<4 hours; * systemic corticosteroids within the last month; * symptoms of primary bacterial pharyngitis or secondary bacterial infection; * serious illness such as tumors; allergy to one of the ingredients; pregnancy or lactation; * hypersensitivity to ibuprofen; * participation in another clinical trial in the previous 30 days.

Keywords: sore throats, pharyngitis acute
immunoregulatory mechanisms of treg cells induced by tocilizumab

Conditions: Arthritis,Rheumatoid

Summary: we can speculate that the best responders to tocilizumab should have multiple related elements (treg cd39, adenosine, il-35) successfully induced and expressed in order to play its beneficial role. the study of these elements and its pathways could help identify the best responders to tocilizumab treatment.


Eligibility criteria:
inclusion criteria: * patients of all sexes, aged ≥ 18 years. * ra patients (according to acr / eular criteria 2010) of moderate to severe activity (das 28\> 3.2 or sdai\> 11), and 6 months or more of evolution, starting treatment with actemra (tocilizumab) or with an anti-tnf, according to the product data. * patients with body weight ≤ 150 kg. * patients who have received written information about the study and gave their informed consent to participate in the study exclusion criteria: * patients with a history of autoimmune disease or inflammatory joint disease other than ra. * patients treated with any investigational agent within 4 weeks (or 5 half-lives of investigational agent, whichever is greater) before starting treatment with tocilizumab