Kornimate/medical-research-clean huggingface dataset:
does emergence time relate with emergence agitation in pediatric patients?

Conditions: Emergence Agitation, Post Operative Behavioral Changes

Summary: emergence agitation (ea) is one of the unpleasant symptoms after general anesthesia. the patient can be irritable, uncooperate, cry, moan and combative behaviors. sometimes the patient may need to be thrashed to prevent physical harm. the mechanism of ea is still unknown. ea is usually self limiting within 45 to 60 minutes after wake up from anesthesia. the incidence of ea is much higher in pediatric group when compared with adult. in some centre the incidence of ea can be up to 67 % depends on anesthesia technique, race, and child's temperament. kain et al, reported that the patient who had marked ea tended to have post operative maladaptive behaviors. these maladaptive behaviors such as insomnia, eating disturbance, aggressive behavior and even developmental regression can be happen until one year after anesthesia. from the previous study, reported that fast emergence was associated with a high incidence of agitation. this prospective observation study is conducted to determine that emergence time has any effect on ea or not. the authors use process electroencephalogram (entropy) to monitor emergence time which defined as the time which state entropy level over sixty to eighty. meanwhile, we will evaluate the emergence time by the conventional method which used the time from ceasing anesthesia to the time of eye opening by normal voice stimuli. the primary outcome of this study is the correlation between emergence time (both from process eeg and clinical presentation) and incidence of emergence agitation. two secondary outcomes will be measured. firstly, the correlation between emergence time and postoperative behavioral changes. secondly, the relationship between entropy monitoring and clinical symptoms.


Eligibility criteria:
inclusion criteria: pediatric patient aged between 3-12 years, asa physical status i-ii who is scheduled for inpatient elective surgery exclusion criteria: emergency surgery, neurosurgery, antiepileptic medication taken and having icu admission planning.
the effects of different therapy regimens on menopausal sleep disorders

Conditions: Menopause; Sleep Disorder

Summary: sleeping disorders are one of the most common menopausal symptoms, which seriously affect health and life quality of perimenopausal women. menopausal hormone therapy is an effective treatment for menopausal symptoms, meanwhile, traditional chinese medicine is also effective to some extent. this prospective randomized controlled study plan to compare the effects of different therapy regimens, including tibolone and xiangshao granules, on menopausal sleep disorders.


Eligibility criteria:
inclusion criteria: * women aged 40-60 * natural menopause for 1-10 years * psqi score \>=11 points * improved k-score\>=14 points * able to independently sign informed consent forms exclusion criteria: * vaginal bleeding of unknown cause * known or suspected breast cancer and other sex hormone dependent tumors * active venous or arterial thromboembolic disease within past 6 months * have used sex hormone or traditional chinese medicine/botanical drugs that affect menopausal symptoms within the past month * have used anti anxiety, depression drugs or sedative hypnotics within the past month * patients with anxiety or depression above moderate level * severe liver or kidney dysfunction, with transaminase or creatinine level exceeding twice of the normal value * bmi ≥ 28 kg/m2 * allergies to research drugs * other situations that doctor deems unsuitable to participate in the study
the changes of retinal capillaries after half-dose pdt measured by octa in eyes with csc

Conditions: Central Serous Chorioretinopathy

Summary: to determine changes in retinal and choroidal capillaries with optical coherence tomographic angiography (octa) after half-dose photodynamic therapy (hd-pdt) in eyes with central serous chorioretinopathy (csc).

pdt was hypothesized to have a primary effect on the choroidal capillaries, and a number of studies have reported choriocapillary damage and choroidal vascular remodeling after pdt. more recently, although octa related csc research has been conducted, no quantitative report has thoroughly investigated the microstructural changes in the superficial, deep retinal and choroidal capillaries after hd-pdt. the purpose of the present study is to determine the changes in the retinal and choroidal capillaries quantitatively with octa after hd-pdt in eyes with csc. this is a prospective observational study of patients undergoing hd-pdt for csc with active leakage in retinal pigment epithelium (rpe) and followed for 3 months. fundus fluorescein angiography (ffa) and indocyanine green angiography (icga) were performed at baseline; best corrected visual acuity (bcva), fundus photography, optical coherence tomography angiography (octa) with the split-spectrum amplitude-decorrelation angiography algorithm (xr optovue, fremont, ca, usa) and spectral domain oct (sd-oct) were performed at baseline and each follow-up visit after hd-pdt.

Eligibility criteria:
inclusion criteria: 1. csc diagnosed by ffa and icga, where the active leakage was just located in macular fovea with srf confirmed by oct 2. patient age ≥18 years 3. bcva ≥35 letters on etdrs charts 4. persistent csc for a period of time or patients were anxiety about the symptom and asking for treatment 5. lack of either spontaneous improvement or improvement induced by empirical treatment such as pharmaceutical drug 6. the provision of written informed consent - exclusion criteria: 1. the presence of any other chorioretinal diseases that may affect the studies, such as age-related macular degeneration (amd), polypoidal choroidal vasculopathy (pcv) 2. patients who had received any previous treatment, including pdt, intraocular drug injection or focal thermal laser photocoagulation for csc 3. patients with ped in macular fovea which the average diameter (transverse diameter and vertical diameter) was more than 300 microns 4. patients with high myopia, defined as a refractive error (spherical equivalent) \ 26.5 mm 5. patients with media opacities, or signal strength index of the images \< 60 6. patients under corticosteroid therapy -

Keywords: central serous chorioretinopathy
maintenance chemotherapy after neoadjuvant chemoradiation therapy for distal rectal cancer

Conditions: Rectal Neoplasms

Summary: this study will assess the complete clinical response (no clinical evidence of remaining disease or recurrence of disease)in rectal cancer that arises within 3 inches of the anal opening after radiation therapy given at the same time as chemotherapy over a 6 week period, followed by chemotherapy alone given three times over an additional 9 weeks. follow-up begins with an examination at the end of treatment (at 15 weeks), with ongoing follow-up every 4-6 weeks for one year.

research has shown that low rectal cancer treated with neoadjuvant chemoradiation (54gy concurrent with 3 cycles of 5-fu/leucovorin) followed by 3 additional cycles of 5fu/leucovorin, followed by close follow-up (every 4-6 weeks for one year)has had good success in achieving complete clinical response, avoiding surgical intervention. if at follow-up remaining disease is found or if there is recurrent disease, surgery can be performed.

Eligibility criteria:
inclusion criteria: * over 18 years old * tumor potentially resectable en bloc; tumors tethered or fixed to a structure that can be removed * clinical/radiological stages t2,t3,or t4, n0-1 * anc \>1500, plt\>100,000 * ast and alkaline phosphatase \< 2.5 x uln * bilirubin \< 1.5 x uln * crcl \> 50 ml/min using cockcroft-gault formula * kps \>60 * ecog performance scale 0-2 * no malignancies within previous 5 years other than non-melanoma skin cancer, in-situ cervical cancer, in-situ ductal breast cancer * no evidence of metastatic disease exclusion criteria: * initial tumor fixation to pelvic bone or side wide; technically unresectable disease * any evidence of distant metastasis * perforation * obstruction * hereditary non-polyposis colorectal cancer * synchronous primary colon carcinomas except t1 lesions * known dihydropyrimidine dehydrogenase deficiency * prior radiation therapy to the pelvis * prior chemotherapy for malignancies * known existing uncontrolled coagulopathy * pregnancy or lactation * women of childbearing potential not using reliable and appropriate contraceptive method * serious, uncontrolled concurrent infection(s) * participation in any investigational drug study within 4 weeks preceding the start of study treatment * clinically significant heart disease * other serious uncontrolled medical conditions that might compromise study participation (in the investigator's opinion) * major surgery within 4 weeks prior to the study treatment * lack of physical integrity of the upper gi tract or malabsorption syndrome

Keywords: fluorouracil leucovorin radiotherapy neoadjuvant therapy
real-world hru and costs in dlbcl pts with tisa-cel and axi-cel, a medicare study.

Conditions: Diffuse Large B-cell Lymphoma

Summary: this was a retrospective non-interventional cohort study design using the centers for medicare and medicaid services (cms) 100% medicare data (2015q1-2020q4). eligible adult patients with r/r dlbcl who were treated with car-t therapy were identified from the cms 100% medicare data. patients who received chimeric antigen receptor modified t cell (car-t) therapy were further classified into tisa-cel and axi-cel cohorts based on the type of car-t treatment received. the index date was defined as the date of tisa-cel or axi-cel therapy administration. baseline period was defined as three months prior to the index date. study period was defined from the index date to the end of health plan coverage based on insurance enrollment file or death, whichever occurred earlier.


Eligibility criteria:
inclusion criteria: * patients had at least one international classification of diseases, 10th revision (icd-10) diagnosis code for dlbcl. * patients received car-t therapy, including both tisa-cel and axi-cel, following dlbcl diagnosis. the administration date of car-t therapy was defined as the index date. * patients were at least 18 years of age as of the index date. * patients had at least three months of continuous health plan enrollment before the index date. exclusion criteria: * patients who had a medical claim associated with a clinical trial within one month before and after the index date. * patients who had zero cost on index date for car-t infusion.
bariatric atrial restoration of sinus rhythm

Conditions: Atrial Fibrillation; Morbid Obesity

Summary: the objective of this study is to determine whether bariatric surgery followed by atrial fibrillation (af) catheter ablation is superior to af catheter ablation alone in the management of atrial fibrillation in patients with morbid obesity.

this will be a multicenter, randomized, controlled, 1:1 allocation trial comparing atrial fibrillation (af) catheter ablation only (group a) to those undergoing bariatric surgery six months prior to af catheter ablation (group b) in patients with paroxysmal or persistent af who also have morbid obesity. participants will be followed for 12 months after their protocol-assigned catheter ablation. scheduled visits group a will be at baseline, 3, 6, and 12 months post af ablation. scheduled visits in group b will be baseline, clinical visit prior af ablation, and at 3, 6, and 12 months post af ablation. at each post ablation visit the following data will be collected: at/af recurrence determined by ambulatory monitoring, clinic visit, or hospitalization; physical exam (weight, height, vitals); 12 lead ecg; medication regimen; af symptom severity scale (afss); quality of life (afeqt); laboratory testing; and adverse events

Eligibility criteria:
inclusion criteria: * symptomatic persistent or paroxysmal af refractory to at least one antiarrhythmic agent * ef \> 40% * bmi \> 40 or bmi \> 35 and at least one of the following co-morbidities: * type 2 diabetes mellitus (by american diabetes association diagnostic criteria). * systolic blood pressure of 130 mmhg and/or diastolic blood pressure 80 mmhg or higher despite medical treatment with maximal doses of three antihypertensive medications). * refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications). * obesity-induced cardiomyopathy. * clinically significant obstructive sleep apnea. * obesity-related hypoventilation. * pseudotumor cerebri (documented idiopathic intracerebral hypertension). * severe arthropathy of spine and/or weight-bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for the obesity). * hepatic steatosis without evidence of active inflammation. * hypertriglyceridemia * polycystic ovary syndrome (pcos) * asthma * coronary artery disease (cad) exclusion criteria: * prior bariatric surgery * prior af catheter ablation * bmi \> 65 kg/m2 * contraindication to bariatric surgery or af ablation * contraindication to therapeutic anticoagulation * sustained af lasting more than 3 years * left atrial diameter of greater than or equal to 60 mm or la volume greater than or equal to 60 ml/m2
evaluation of von willebrand factor as a marker for early diagnosis of acute respiratory distress syndrome (a.r.d.s) in comparison to interleukin 6 [il-6]

Conditions: ARDS, Human

Summary: in this prospective study of 60patients, we tested the hypothesis that markedly elevated levels of plasma von willebrand factor (vwf) a marker of endothelial cell injury might predict the development of acute respiratory distress syndrome (a.r.d.s) in risky patients. we compared our result to il.6 as control biomarker for a.r.d.s development. acute lung injury was quantified on two -point scoring system (berlin definition of ards and murray score of acute lung injury). plasma levels of both vwf and il.6 were be measured on t=0 i.e. (at start of the study once the patient considered to be risky for a.r.d.s development to obtain their baseline levels), t=48 (after 48 hours), and t=72 (after 72 hours).


Eligibility criteria:
inclusion criteria: * patients between 18 and 80 years old of both sexes. * risk factor for development of acute respiratory distress syndrome or acute lung injury either by: * direct lung injury includes: severe pneumonia (infection), breathing a vomited stomach contents (aspiration), breathing harmful fumes or smoke, severe trauma to the chest or other accident that bruises the lungs. * indirect lung injury includes: sepsis, severe injury or trauma with shock, blood transfusions , drug overdose acute pancreatitis, fracture of the long bones, near drowning ,anaphylaxis, uremia, fat embolus , and intracranial insult. exclusion criteria: * (1) pregnancy; * (2) a preexisting medical condition with a life expectancy less than 3 months * (3) evidence of cardiogenic pulmonary edema * (4) age under 18 years old or above 80 years old * (5) late stages of liver cell failure, renal failure * (6) severe myocardial infarction * (7) deep coma.
role of the toxic metal cadmium in the mechanism producing infertility with a varicocele

Conditions: Varicocele; Male Infertility; Hypospermatogenesis; Non-Obstructive Azoospermia

Summary: varicose veins in the scrotum (varicocele) are responsible for \>20% of male infertility in the us. varicocele are associated with decreased sperm number and markedly reduced sperm fertilizing ability. surgical repair or removal of varicocele restores fertility in only 1/3 of cases. the goal of this study is to identify markers that predict the outcome of variocele correction. this would offer considerable health cost savings. based on preliminary findings, we will obtain testis biopsies and semen specimens from infertile men with varicocele and prospectively examining the levels of cadmium, a toxic metal, and expression of genes required for normal sperm function. the semen and biopsies will be obtained during clinically dictated procedures. cadmium and gene expression will be compared with response to varicocele repair (i.e., increased sperm production; pregnancy).


Eligibility criteria:
* healthy male with varicocele (grades 2 \[palpable\] or 3 \[visible, palpable\]) and no other diagnosed cause for infertility * non-smoker * actively desiring children but never having initiated a pregnancy * female partner having no unresolved fertility issues

Keywords: varicocele environmental toxins male infertility cadmium
personalized experiences to inform improved communication for patients with life limiting illness

Conditions: Heart Failure; Renal Failure

Summary: disparities in palliative care for patients with serious illness exist because of gaps in knowledge around patient centered psychological, social, and spiritual palliative care interventions. patient-centered palliative care communication interventions must be informed by the perspectives of patients who are living each day with their serious illness. yet, there is a lack of research about how to efficiently and effectively integrate the patient's narrative into the electronic health record (ehr). the central hypothesis of this proposal is that the implementation of a patient-centered narrative intervention with patients with serious illness will result in improved patient-nurse communication and improved patient psychosocial and spiritual well-being.

the overall goal during this study will be to conduct a small scale pilot study with 80 hospitalized patients and 80 acute care nurses. specific aim 1 will establish acceptability, feasibility, and potential effect size of the patient-centered narrative intervention for hospitalized patients with serious illness. for specific aim 2, the investigators will compare the effects of the narrative intervention to usual care for the primary outcome of patient's perception of quality of communication and patient's psychosocial and spiritual well-being. for specific aim 3, the investigators will conduct usability testing, applying a user-task-system-environment evaluation process to determine essential requirements for integration and use of the patient-centered story into the ehr, from the perspective of an important end user: the acute-care bedside nurse. these results will support future r01 applications for testing/tailoring patient-centered narrative interventions to improve qol for patients living with serious illness.

Eligibility criteria:
inclusion criteria: * age 18 years or older. * has ability to read english. * capable of giving informed consent. * has diagnosis of at least one serious illness. for this study, the eligible diagnoses include: 1) new york heart class iii or iv heart failure and/or 2) dialysis-dependent renal failure exclusion criteria: - none.
a proof of concept study of serum progesterone levels for ivf/icsi following hcg trigger for oocyte maturation

Conditions: Infertility; Infertility, Female; IVF; hCG

Summary: this study will determine the rise of progesterone levels after human chorionic gonadotrophin (hcg) trigger in stimulated cycles ivf/icsi

studies have suggested that controlled ovarian hyperstimulation adversely affects endometrial receptivity. in ovarian stimulation cycles with exogenous gonadotrophins there is an ongoing debate regarding the effect of a late follicular phase progesterone level on reproductive outcomes. it is not yet clarified if an elevated serum progesterone level in the late follicular phase is a symptom or cause of an adverse effect on reproductive outcomes. a new hypothesis is evolving and gaining momentum providing a novel explanation for the association between late follicular phase progesterone rise and reproductive outcome. it is proposed that exogenous fsh (follicle-stimulating hormone) administration results in supraphysiological levels of fsh, which induce an abundance of lh (luteinizing hormone) receptors on granulosa cells causing the follicles to become hypersensitive to lh-like activity (ie hcg trigger). based on this hypothesis, the focus should be placed on the hcg trigger rather than on the late follicular phase progesterone rise.

Eligibility criteria:
inclusion criteria: * females aged 18 to 42 years with regular menstrual cycles of 26-34 days * undergoing ovarian stimulation for ivf/icsi \& pgs. * receiving recombinant fsh for stimulation * hcg 5000iu im as trigger injection for oocyte maturation. * ovarian stimulation in gnrh-antagonist protocols * bmi 18- 35 kg/m2 * having 1 or 2 euploid embryos for transfer in spontaneous natural cycles. exclusion criteria: * poor ovarian reserve as defined by bologna criteria * pcos in accordance with rotterdam criteria
the hip-hop flooring study: helping injury prevention in hospitalised older people

Conditions: Accidental Falls

Summary: in hospitals, older people can fall and hurt themselves. the investigators want to see if a new type of flooring can help stop people hurting themselves as badly, if they accidentally fall.

we will carry out the study in eight elderly care wards across england. we will first study the wards for up to 6 months. then, half of the wards will have the new floor laid. wards will be chosen to receive the new floor, or remain with a standard floor, by chance. the new floor has 'shock-absorbent' properties. we will study all the wards for another 12 months. this will allow us to compare the new flooring with the normal flooring.

Eligibility criteria:
inclusion criteria: * all patients admitted to the study area on a participating elderly care ward exclusion criteria: * none.

Keywords: floors and floorcoverings health services for the aged fractures, bone delirium, dementia, amnestic, cognitive disorders frail elderly aged, 80 and over