Kornimate/medical-research-clean huggingface dataset:
outcome of multimodal anesthesia bern

Conditions: Opioid Use; Pain, Postoperative; Postoperative Complications; Postoperative Nausea

Summary: in the context of the ongoing opioid crisis in the usa and europe, reducing perioperative opioid use is a growing priority. multimodal anesthesia (mma) offers a patient-centered alternative to opioid-free anesthesia, combining regional techniques, non-opioid analgesics, and adjunct therapies to enhance pain control while minimizing opioid reliance. by targeting multiple pain pathways, mma can improve recovery outcomes, reduce side effects, and optimize resource use, representing a potential paradigm shift in perioperative medicine. this study compares (patient-centered) outcomes after application of mma (a standardized combination of magnesium, ketamine, lidocain and dexmedetomidine before and during surgery in combination with opioids) with an opioid based general anesthesia regimen in the context of major surgery.


Eligibility criteria:
inclusion criteria: * existing informed consent * german, italian or french speaking * age 18 or more * planned duration of surgery 60min or more * inpatients and postoperative transfer to pacu or 24h icu exclusion criteria: * palliative or emergency procedures * reoperation (e.g. 2nd look) * bariatric surgery patients * pregnancy / breastfeeding * adults legally protected * known allergy or contraindication to interventional medication

Keywords: multimodal anesthesia
myoelectric activity and mandibular movement for the diagnosis of temporomandibular disorder

Conditions: Temporomandibular Disorder

Summary: this study aimed to provide normal reference values of surface electromyography (semg) and mandibular kinematics in chinese young adults, compare the sex differences and assess the diagnosis value of these indices.

temporomandibular disorders (tmd) are one of the leading causes of craniofacial pain, and a high incidence of tmd in young adults has been reported. previous studies have used semg and mandibular kinematic analysis to diagnose tmd. this was an observational study that healthy young adults with individual normal occlusion were strictly selected by diagnosis standard, and tmd patients with disc displacement were recruited. the semg signals of the anterior temporalis (ta), masseter (mm), and sternocleidomastoid and digastric were recorded in the mandibular postural positions (mpp) and during maximal voluntary clenching (mvc) with k7 electromyograph. mandibular kinematics, including maximum opening and opening/closing velocities, were assessed by k7 kinesiograph.

Eligibility criteria:
inclusion criteria: * centred midline and no marked restriction and deviation of mouth opening and closing; ·overjet and overbite of 1-3 mm, bilateral molar support with molar and cusp relation of angle's class i; * presence of complete permanent dentition, except third molars. exclusion criteria: * history of local or general trauma; * presence of systemic diseases, neurological or psychiatric disorders, muscular diseases, cervical pain, or tmd based on the research diagnostic criteria (rdc); * pregnancy; * consumption of anti-inflammatory, analgesic, antidepressant, or myorelaxant drugs; * presence of parafunctional facets and anamnesis of parafunctional tooth clenching, bruxism, or unilateral chewing; * presence of obvious dentition crowding or spacing, malposed, supernumerary or fractured tooth, visible caries, tooth abrasion/hypersensitivity, toothache, periodontal disease, or occlusal discomfort; * fixed or removable restorations, tooth filling, or occlusal adjustment that affected the occlusal surfaces; * previous or concurrent orthodontic, orthognathic, or tmj treatment.

Keywords: temporomandibular joint disorder; surface electromyography; mandibular kinematics; sex difference; diagnosis.
uterine massage after vaginal delivery

Conditions: Postpartum Hemorrhage

Summary: the participants will be randomized into an oxytocin plus uterine massage group and an oxytocin-only group in the third stage of the labor. women allocated to the uterine massage group will be provided with trans-abdominal uterine massage starting promptly after delivery of the fetus until delivery of the placenta. the amount of postpartum hemorrhage and placental delivery time will be recorded and compared between the groups.

women allocated to oxytocin only group will be given 10 units of oxytocin intramuscularly immediately after delivery of the fetus. women allocated to the oxytocin plus uterine massage group will be will be given 10 units of oxytocin intramuscularly immediately after delivery of the fetus and will be provided with trans-abdominal uterine massage starting promptly after delivery of the fetus until delivery of the placenta. collection of blood loss will be initiated immediately after delivery of the fetus by putting a drape under the woman's buttocks. collected blood will be weighed and the amount will be recorded in grams.

Eligibility criteria:
inclusion criteria: * 18-40 years old women delivering vaginally exclusion criteria: * women with bleeding disorder
treatment of uncomplicated malaria in benin

Conditions: Uncomplicated Malaria

Summary: malaria is a life-threatening disease especially in small children. a high degree of plasmodium falciparum resistance to chloroquine has already spread to south-benin where this study is taking place. in the past few years, the recommendation for a first-line treatment in this area has moved from chloroquine to sulfadoxine-pyrimethamine (sp). there is growing evidence that plasmodium falciparum resistance to sp has come to south-benin. the aim of the study is to compare the efficacy of sp to two compact artemisinin-based therapies (act): artemether-lumefantrine and the amodiaquine-artesunate coformulation. act will be unsupervised. the primary endpoint is an effectiveness comparison (pcr corrected) at day 28. secondary outcomes are effectiveness comparisons (pcr corrected) at day 14 and 42 and a study on the relationships between act pk data (day 3) and outcome. expected total enrollment: 225 patients study start: april 2007; expected completion: december 2007


Eligibility criteria:
inclusion criteria: * 6-119 months old * fever or history of fever of less than 24 hours * p falciparum parasitemia \> 1000 trophozoïtes/µl * informed consent signed exclusion criteria: * \< 5 kg * danger or severity signs of malaria * known underlying chronic disease * hb \< 5g/dl * adequate malaria treatment taken within 3 days before visit

Keywords: uncomplicated malaria children treatment effectiveness
investigation of efficacy of use of a bandage

Conditions: Hip Dislocation

Summary: this trial investigates the effectiveness of using a bandage after dislocation of the hip after total hip arthroplasty. patients with a dislocated hip after total hip arthroplasty coming to the emergency department to have the hip relocated will be asked to participate in the trial. the patients will be randomised to either a bandage that reduces flexion, adduction and internal rotation of the hip or no bandage.

this trial investigates the effectiveness of using a bandage after dislocation of the hip after total hip arthroplasty. patients with a dislocated hip after total hip arthroplasty coming to the emergency department to have the hip relocated will be asked to participate in the trial. the patients will be randomised to either a bandage that reduces flexion, adduction and internal rotation of the hip or no bandage. patients in the intervention group will use the bandage for 12 weeks and patients in the control group will receive the normal treatment which is information by a physiotherapist on movement restrictions. 50 patients will be allocated in the intervention group and 50 patients will be allocated to the control group. we will investigate: 1. whether there is a difference in number of dislocations between the two groups in the project period (12 weeks). 2. patients' hip function, quality of life and satisfaction with the treatment in the two groups 3. the safety, wear and durability of the bandage after 12 weeks of use

Eligibility criteria:
inclusion criteria: * has had at least one previous hip dislocation after total hip arthroplasty exclusion criteria: * dislocation in other directions than posterior/superior * loose prosthesis * wounds in the area of skin that is in contact with the bandage
clinical study on sitagliptin for assessment of glucose-lowering effects (0431-045)

Conditions: Diabetes Mellitus, Non-Insulin-Dependent

Summary: a clinical study determines the safety and efficacy of sitagliptin (mk0431) in patients with type 2 diabetes mellitus who have inadequate glycemic control on diet/exercise therapy


Eligibility criteria:
inclusion criteria: * patients have type 2 diabetes mellitus on diet/exercise therapy exclusion criteria: * patients have type 1 diabetes mellitus
fetal, obstetrics and reproduction genomics

Conditions: Preeclampsia; Intrauterine Growth Restriction; Placental Disease

Summary: the purpose of this study is to determine the impact of a clinical screening strategy and genomic analysis of the factors involved in placental dysfunction (preeclampsia and iugr) in women of advanced maternal age undergoing assisted reproduction techniques (art), specifically, in vitro fertilization (ivf) and oocyte donation.

given society's shift towards later childbearing, partly related to increased career development, women are increasingly delaying childbearing and, as a result, face declining biological fertility and increased maternal morbidity and adverse perinatal pregnancy outcomes, as well as increased use of art. preeclampsia (pe) complicates 2% of pregnancies and is a leading cause of severe maternal and perinatal complications. there is no curative treatment, and the only recognized beneficial primary prevention is low-dose aspirin. finding an effective method of predicting and preventing placental dysfunction (pd) in women of advanced maternal age undergoing art remains a challenge. the investigators believe that maternal and perinatal complications in this group of pregnant women could be detected preclinically and allow early preventive actions. on the other hand, establishing a differentiated genomic pattern in this group of patients would allow preventive actions both pregestational and during gestation. furthermore, forgenomics can be used to externally validate a prediction model for the development of pe and iugr in pregnancy after ivf/ovodon. our results could be applicable in most healthcare settings and have important implications for maternal-fetal health. the justification and hypothesis of this proposal is: (1) maternal and perinatal complications in this group of pregnant women could be detected preclinically and allow preventive actions by systematic screening based on doppler ultrasound of uterine arteries and anti-angiogenic factors (sflt-1/plgf ratio) at 13, 16, 20 and 26 weeks to identify pregnant women at high risk for developing pe; (2) morphological ultrasound at 13, 16 and 20 weeks would help to establish a standardized procedure for early detection of congenital anomalies and (3) establishing a differentiated genomic pattern in this group of patients would allow preventive actions both pregestational and during gestation.

Eligibility criteria:
inclusion criteria: * singleton pregnancy * age ≥40 years * signed informed consent * gestation obtained by ivf or ovodonation exclusion criteria: * non-ongoing pregnancy * gestation obtained by artificial insemination * naturally obtained gestation, without art * multiple pregnancy * pregnancies complicated by major fetal abnormality identified at the first-trimester ultrasound * age \<18 years * poor understanding of the spanish or english languages * refusal in informed consent to participate in the study * participation in another intervention study that could modify follow-up

Keywords: preeclampsia intrauterine growth restriction genomics
deuterium metabolic imaging to assess radiotherapy changes in glioblastoma multiforme

Conditions: Glioblastoma Multiforme

Summary: this is a feasibility single arm study designed for obtaining early data for optimization and evaluation of the clinical potential for a new mr technique using deuterated glucose. the purpose of the study is to investigate whether this technique is useful in metabolic imaging of glioblastoma multiforme (gbm) and whether radiochemotherapy (rct) induced changes in the brain metabolism can be detected and might be predictive for treatment response. the study will include 10 patients with histologically verified gbm scheduled for standard rct. patients will have mri scan performed before and within 8 weeks after starting rct. the scans will include imaging after oral intake of deuterated glucose, so called deuterium metabolic imaging (dmi). based on this study, the most optimal scanning technique, output variables of highest discriminative power with respect to rct, and potential predictive markers for response will be selected for further clinical investigation.


Eligibility criteria:
inclusion criteria: * patients with newly diagnosed gbm idhwt * scheduled for long-course radiotherapy * at least 18 years of age * who performance status 0-1 * women who are not postmenopausal or surgically sterile must have a negative serum or urine pregnancy test performed at time of inclusion in the study. safe and highly effective contraception must be used throughout the study meaning either hormonal anti-conception or an anti-fertility intrauterine device. * danish speaking * able and willing to comply after informed consent exclusion criteria: * subjects who are receiving any other investigational agents. * previous or current treatment by radiation or chemotherapy. * history of alcohol abuse or illicit drug use. * contraindications to mri pacemaker, neurostimulator or cochlea implant metal foreign bodies such as fragments and irremovable piercings unsafe medical implants intracranial clips or coils claustrophobia largest circumference including arms \> 160 cm * contraindications to gadolinium contrast egfr ≤ 30 ml/min/1.73m2 previous adverse reactions to gadolinium * not able or willing to receive radiotherapy * predicted remaining survival \<3 months * insulin-treated diabetes
shared decision-making structured team model for critical maternal care in ob-gyn icu

Conditions: Critical Illness; Pregnant Women

Summary: a randomized controlled trial was conducted with 100 critically ill pregnant women admitted to our hospital's obstetrics icu between january 2023 and december 2024. participants were allocated via random number table to either the control group receiving conventional multidisciplinary resuscitation care (n=50) or the observation group receiving the structured team model with shared decision-making (n=50). comparative outcomes included resuscitation efficiency indicators (pre-hospital response time, intrahospital transport duration, emergency supply preparation time), complication rates, family psychological status measured by hospital anxiety and depression scale (hads), and family satisfaction assessments


Eligibility criteria:
inclusion criteria: * meeting diagnostic criteria for critical obstetric conditions: 1. amniotic fluid embolism 2. postpartum hemorrhage 3. emergency cesarean section was performed, etc * age ≥18 years * gestational age \>20 weeks * patient's family/legal representative capable of normal communication and providing signed informed consent exclusion criteria: * pre-existing primary hematologic disorders: * fetal congenital anomalies confirmed by prenatal imaging * active malignant tumors (except carcinoma in situ) * severe organ dysfunction: * altered mental status (gcs ≤12) or documented psychiatric disorders
safety and the effects of isolated left ventricular pacing in patients with bradyarrhythmias

Conditions: Bradyarrhythmias; Arrhythmias; Atrioventricular Block; Ventricular Dysfunction; Cardiovascular Disease

Summary: previous experimental and clinical studies have consistently suggested that right ventricular (rv) apical pacing has important adverse effects. ventricular pacing, however, is required, and cannot be reduced in many patients with atrioventricular block. the safe-lvpace study is a randomized controlled trial that compare the effects of conventional right ventricular (rv) pacing vs. left ventricular (lv) in patients with av block.

over the past several years, there has been growing concern over the significant deleterious effects of rv pacing, including electromechanical dyssynchrony, proarrhythmia and development of heart failure (hf). however, it remains unclear whether pacing-related ventricular dyssynchrony can translate into significant lv structural changes and produce important clinical impairment in an average pacemaker population with compromised av conduction. alternatively, left ventricular pacing has been shown to minimize ventricular dyssynchrony and to improve symptoms and prognosis in patients with mild to moderated systolic hf and prolonged qrs duration. this randomized controlled study is been conducted to compare the effects of conventional right ventricular (rv) pacing vs. left ventricular (lv) in patients with av block. the hypothesis is that isolated lv pacing through the coronary sinus can be used safely and provide greater hemodynamic benefits to patients with av block and normal ventricular function who require only the correction of heart rate. specifically, the investigator aims are to evaluate the safety, efficacy and the effects of left ventricular pacing using active-fixation coronary sinus lead-the attain starfix® model 4195 otw lead, compared to right ventricular pacing in patients with implantation criteria for conventional pacemaker stimulation.

Eligibility criteria:
inclusion criteria: * older than 18 years * pacemaker initial implant by transvenous approach * presence of av block * presence of atrial fibrillation / atrial flutter with slow ventricular response * left ventricular systolic function \> 0.40 * subject agreed to participate and signed the consent form exclusion criteria: * absence of venous access * impediment of venous access due to presence of intracardiac defects * impediment of venous access due to presence of tricuspid valve prosthesis * need for radiotherapy in the chest * presence of chest deformity * pregnancy * life expectancy of less than one year * contraindication to administration of iodinated contrast (creatinine \> 3.0) unable to attend the follow-up appointments

Keywords: pacemaker pacemaker implantation coronary sinus ventricular dysfunction right ventricular pacing left ventricular pacing
in vitro maturation (ivm) of human oocytes

Conditions: Polycystic Ovarian Syndrome (PCOS); Patients Sensitive to Exogenous Gonadotropins; Ovarian Hyper Stimulation Syndrome (OHSS)

Summary: we hypothesize that the combination of natural cycle ivf or low dose gonadotropin injection combined with in vitro maturation (ivm) (natural ivf/ivm) is a viable option for a selected population of infertility patients who cannot tolerate exogenous gonadotropins or are at risk of ovarian hyperstimulation syndrome.

natural ivf/ivm may be an attractive treatment alternative to conventional controlled ovarian hyperstimulation (coh)/ivf treatment for infertile women in particular for a select group. natural ivf/ivm offers several advantages over conventional coh protocols for ivf including: 1. elimination of the need for gonadotropin ovarian stimulation 2. elimination of risk of developing ohss 3. simplification of treatment, eliminating the need for frequent blood tests and ultrasound monitoring 4. reduced cost of treatment 5. avoiding potential side effects of gonadotropins, including weight gain, bloating, breast tenderness, nausea, mood swings 6. eliminates concerns about the potential risk of malignancy that may be associated with multiple cycles of ovarian stimulation in a predisposed population. this pilot study will be conducted to assess the clinical efficacy of natural ivf/ivm

Eligibility criteria:
inclusion criteria: 1. each subject must be female. 2. each subject must have an indication for coh and ivf or icsi. 3. each subject must be willing and able to provide written informed consent for the trial. 4. each subject must be ≤42 years of age at the time of signing informed consent. 5. each subject must have a normal cervical smear result (no atypical or abnormal cells, or in case of atypical squamous or glandular cells, no signs of malignancy; corresponding to papanicolaou \[pap\] i or ii) obtained within 12 months prior to signing informed consent must be available. exclusion criteria: 1. subject with premature ovarian failure. 2. subject with endocrine abnormalities such as hyperprolactinaemia or thyroid dysfunction. 3. subject with malformation or absence of uterus. 4. subject tested positive for human immunodeficiency virus (hiv) or hepatitis b (by local laboratory; results obtained within 1 year prior to signing icf are considered valid). 5. subject with contraindication or allergy/hypersensitivity to hcg, estrogen and progesterone.

Keywords: in vitro maturation ivm natural cycle ivf pcos
treadmill therapy and brain injuries

Conditions: Cerebral Stroke; Hemiplegia; Moderate to Severe Functional Impairments

Summary: introduction. * there is a demand for evidence whether treadmill therapy is more efficient than traditional walking training as an intervention for patients with hemiplegia after cerebral stroke. design. * a randomized controlled trial. material. * stroke patients with moderate to severe functional deficits referred to inpatient medical rehabilitation. method. * comparing a treatment group receiving treadmill training with body weight support with a treatment group receiving conventional walking training. study aim: * investigate whether treadmill therapy is more effective than traditional functional training in restoring walking and transfer in patients with moderate to severe ambulatory deficits after stroke.

see "brief summary".

Eligibility criteria:
inclusion criteria: * cerebral stoke * hemiplegia * primary rehabilitation * medical stable * wheelchair user * dependent of assistance for walking * dependent of maximum one person for transfer * no physical impairments that could prevent walking ability from being restored * able to participate in the training modalities exclusion criteria: * medical unstable * orthopaedic or other impairments preventing relearning walking * cognitive impairments that prevents understanding the study information * cognitive or psychological impairments that prevents study collaboration

Keywords: brain injury rehabilitation treadmill therapy