Kornimate/medical-research-clean huggingface dataset:
perioperative continuous glucose monitoring

Conditions: Diabetes Mellitus

Summary: to evaluate use of continuous glucose monitoring (cgm) technology in the preoperative setting: evaluate feasibility of placement of cgm during preoperative clinic visit with intent to utilize cgm throughout perioperative period.

to further study potential barriers related to loss of continuous glucose monitoring (cgm) data as it relates to use of electrocautery and grounding devices utilized in the perioperative setting. to assess how cgm technology could improve glycemic management in the perioperative setting, specifically in predicting and preventing hypoglycemic episodes as well as utilization for treating hyperglycemia with resultant improvement in patient morbidity, mortality, length of stay, and overall quality of life. cgm technology aids tremendously in data collection with recognition of glycemic patterns, as well as evaluating prediction of blood glucose changes including both hyperglycemic and hypoglycemic events. the availability of such a large volume of glycemic data has been shown to make a tremendous impact in patient care, resulting in statistically significant reductions in hemoglobin a1c, a decrease in hypoglycemia, a decrease in hospital admissions for diabetes complications, and improved overall quality of life and fear of hypoglycemia in patients using cgm technology.

Eligibility criteria:
inclusion criteria: * participants that are 18 years of age or older with hyperglycemia and/or diabetes mellitus who will be undergoing surgery at atrium health wake forest baptist * smartphone compatible with libre 2 phone application exclusion criteria: * pregnant women will not be excluded from this study * participants undergoing surgery that would limit the placement of continuous glucose monitoring (cgm) to the posterior aspect of the upper extremity will be excluded from this study * neurosurgical type of surgery

Keywords: a1c blood glucose changes hyperglycemic and hypoglycemic events
community-based post-exposure prophylaxis for covid-19

Conditions: Covid19

Summary: specifically identified ayurvedic preparations is recommended by ministry of ayush as post-exposure prophylaxis to efficaciously prevent a negative person who has come into contact with covid-19-positive. traditionally, recommended ayurvedic preparations have been used as antioxidants, antimicrobial and anti-inflammatory properties. particularly, guduchi ghanvati has been recognised with its ability to control viral attachment, viral replication and induce immune response in pre clinical settings, and found to be one among the most important drugs in ayurveda to fight against covid-19. however, known gap in guideline implementation and its impact on preventing active infection in exposed cases is unclear. study aimed to increase the use of recommended ayush guidelines by having registered ayush physicians provide these medications, when indicated, in community based participants after known exposure to the sars-cov-2 coronavirus.


Eligibility criteria:
inclusion criteria: * men or women 18 to 60 years of age * household contact residing with the index case in the 14 days prior to index diagnosis within a residence without maintaining social distance * access to device and internet for telephonic appointments and follow up exclusion criteria: * currently hospitalised * symptomatic with fever, cough, or shortness of breath * use of anti-malarial treatment or chemoprophylaxis * moderately or severely ill for any co-morbid condition requiring medical assistance. * cognitive impairment

Keywords: post exposure prophylaxis
opioid-free anesthetic for tonsillectomy

Conditions: Anesthesia; Opioid Use; Tonsillitis; Sleep Disorder; Surgery

Summary: prospective randomized controlled trial to determine if opioid-free anesthetic for tonsillectomy is non-inferior to standard opioid-containing anesthetic

objectives: primary: to determine if an opioid-free anesthetic provides equivalent acute postoperative pain relief in tonsillectomy. secondary: to determine if post-operative pain at home is not significantly different with an opioid-free regimen compared to an opioid containing regimen for tonsillectomy. study design: prospective, randomized, multi-center trial study study interventions and measures: subject will be randomized to 1:1 intra-operative opioid-free (ofg) vs traditional care anesthetic with opioids (tcg) group the primary endpoint is the median pain score (calculated by a blinded validated observer in the recovery room at two time intervals) between the two cohorts.

Eligibility criteria:
inclusion criteria: 1. males or females age 2 to 18 years. 2. american society of anesthesiologists {asa) ≤ 3 physical classification system 3. girls after menarche must have a negative pregnancy test. 4. scheduled tonsillectomy or tonsillectomy combined with adenoidectomy and/or ear tube placement at the children's hospital of philadelphia (chop) main or ambulatory surgical centers. 5. parental/guardian permission (informed consent) and if appropriate, child assent exclusion criteria: 1. current (within the last 30 days) opioid use for pain control 2. high risk for surgical site hemorrhage, determined by bleeding disorder diagnosis or evidence or poor hemostasis 3. multiple scheduled surgeries at the same time other than adenoidectomy and/or ear tube placement 4. history of drug abuse, chronic pain, bleeding disorder 5. chronic disease such as sickle cell disease for which treatment with opioids may be clinically indicated 6. significant congenital disorders, medication allergies or comorbidities, specifically a pre-disposition to bradycardia or conduction abnormalities, cyanotic cardiac disease and use of medications that would increase risk of bleeding or bradycardia. 7. history of hepatic dysfunction, renal dysfunction, thrombocytopenia, or anemia (including pre-surgery laboratory abnormalities) 8. history of hypersensitivity to nsaids 9. patients with asthma, including patients who have experienced aspirin- or nsaid-sensitive asthma or a history of exacerbation when aspirin or nsaids are administered (e.g. bronchospasm, urticaria, etc.) 10. subjects receiving medications that could impact metabolism of either study drug should also be excluded 11. trisomy 21 diagnosis 12. parents/guardians or subjects who, in the opinion of the investigator, may be non-compliant with study schedules or procedures. 13. patients on a ketogenic diet 14. parents or subjects who do not speak english

Keywords: tonsillectomy opioid-free ketorolac dexmedetomidine acute postoperative pain relief opioid morphine fentanyl
early noninvasive positive pressure ventilation in children with status asthmaticus

Conditions: Status Asthmaticus

Summary: status asthmaticus is recognized as a common cause of morbidity in children in the united states. in recent years, hospitalization rates have reached an all time high. this study will evaluate the safety, tolerability and clinical benefit of adding noninvasive positive pressure ventilation (nppv)to regular care in children with moderate to moderately severe status asthmaticus.

status asthmaticus is defined as severe asthma that fails to respond to inhaled short acting β agonists (saba), oral or intravenous steroids, and oxygen, leading to hospital admission for further management (1). in 2004, asthma exacerbations led to 3% (198,000) of all hospitalizations and 2.5 deaths per 1 million populations in the 0-17 year age group (2). this prospective, unblinded, randomized controlled, pilot clinical trial will compare nppv plus standard of care versus standard of care alone in children admitted for status asthmaticus. nppv refers to the delivery of pressurized gas through an external interface such as a nasal or oronasal mask, connected to a pressure targeted ventilator. in other words, it provides ventilator support without the use of an endotracheal tube. this study will investigate the safety, tolerability and efficacy of early initiation of non-invasive nppv in pediatric patients admitted with status asthmaticus.

Eligibility criteria:
inclusion criteria: * children, 1- 18 years of age, with a known history of asthma admitted to the picu at st john's children's hospital with status asthmaticus * clinical asthma score (cas) between 3 - 8 after receiving one dose of systemic steroid, 1 hour of continuous albuterol (saba), and 3 doses of ipratropium bromide * written informed consent from the patient's parent or legal guardian exclusion criteria: * no previous history of asthma, * absence of airway protective reflexes, * absence of respiratory drive, * excessive oral secretions, * need for emergent intubation as determined by the attending physician, * facial or airway anomaly or injury precluding the use of tight fitting mask

Keywords: status asthmaticus noninvasive positive pressure ventilation asthma in children
enteral nutrition in acute pancreatitis

Conditions: Acute Pancreatitis

Summary: the purpose of this prospective randomised clinical trial is to compare beneficial and harmful effects of the use enteral nutrition versus a nil-by-mouth and intravenous fluid replacement principle of treatment in patients with moderate to severe acute pancreatitis (ap). the hypothesis: * enteral nutrition is no significantly better compared with the nil-by-mouth principle regarding mortality, incidence of local and systemic complications, length of hospital stay, and intensity of the inflammatory response in patients with moderate to severe ap * enteral nutrition has the same safety as nil-by-mouth principle in patients with moderate to severe ap

patients with first attack of ap irrespective of etiology will be enrolled in the study, if they are eligible according to the following criteria: inclusion criteria: * onset of symptoms consistent with ap within 72 hours before admission to the hospital * an 3-fold elevation of serum amylase or serum lipase over the upper limit of normal * apache ii score 6 or more * a signed informed consent exclusion criteria: * patients \< 18 years of age * pregnant and breastfeeding women

Eligibility criteria:
inclusion criteria: * onset of symptoms consistent with ap within 72 hours before admission to the hospital * an 3-fold elevation of serum amylase or serum lipase over the upper limit of normal * apache ii score 6 or more * a signed informed consent exclusion criteria: * patients \< 18 years of age * pregnant and breastfeeding women

Keywords: pancreatitis, acute necrotizing enteral nutrition fasting complications mortality
solace stress urinary incontinence control efficacy and safety study

Conditions: Stress Urinary Incontinence

Summary: the success trial is designed to determine whether the solace bladder control system is safe and effective for the treatment of stress urinary incontinence (sui) in adult females.

subject will undergo treatment with the solace bladder control system or a sham procedure, with the results being compared at 3 months. all patients undergoing sham treatment are treated at 3 months.

Eligibility criteria:
inclusion criteria: * female 18 years of age or older with stress urinary incontinence (sui) * experienced sui for at least 12 months and attempted and failed prior noninvasive treatment * willing to undergo cystoscopic procedures required and 36 month follow-up * on stable medication for a minimum of 3 months * free of local genital skin infection * positive pad weight test * free of impassable urethral strictures, trauma or necrosis exclusion criteria: * pregnant or planning to become pregnant during the study period * non-ambulatory or bedridden or physically unable to complete test exercises * morbidly obese (defined as bmi ≥ 40 kg/m2) * incontinence of neurogenic etiology * urge predominant mixed incontinence * bladder infection (including bladder inflammation or edema) or urinary tract infection (uti) within 3 months * history of recurrent urinary tract infections * prior surgical procedure for incontinence within the past 6 months * is taking medications for urinary incontinence other than anticholinergics * history of recurrent (\>1) or recent (within 5 years) kidney stone(s) * has a prosthetic heart valve * unable to tolerate any form of antibiotic * taking anticoagulation therapy, other than aspirin * has urinary incontinence due to intrinsic sphincter deficiency (isd)

Keywords: stress urinary incontinence sui
assessment of lipid profile in cirrhotic patients

Conditions: Cirrhosis

Summary: cirrhosis is defined anatomically as a diffuse process with fibrosis and nodule formation. it is the result of the fibrogenesis that occurs with chronic liver injury. lipoproteins are complexes of lipid and proteins that are essential for transport of soluble vitamins liver cells play a serious task in the regulation of lipid metabolism. the principal location for lipoprotein and cholesterol synthesis is in the liver. in healthy individuals, a compound equilibrium is preserved between utilization, biosynthesis, and transfer of lipid fractions. many diseases that affect the parenchyma can lead to changes in the structure of lipoproteins and transport throughout the blood. nevertheless, in cirrhotic patients, the metabolism of lipid is changed such that glycogen stores are significantly diminished, contributing to malnutrition and biolysis.

cirrhosis is defined anatomically as a diffuse process with fibrosis and nodule formation. it is the result of the fibrogenesis that occurs with chronic liver injury. lipoproteins are complexes of lipid and proteins that are essential for transport of soluble vitamins liver cells play a serious task in the regulation of lipid metabolism. the principal location for lipoprotein and cholesterol synthesis is in the liver. in healthy individuals, a compound equilibrium is preserved between utilization, biosynthesis, and transfer of lipid fractions. many diseases that affect the parenchyma can lead to changes in the structure of lipoproteins and transport throughout the blood. nevertheless, in cirrhotic patients, the metabolism of lipid is changed such that glycogen stores are significantly diminished, contributing to malnutrition and biolysis. the preceding studies have reported that cirrhotic patients have abnormal metabolism of lipids, especially reduction in cholesterol level and hypobetalipoproteinemia. these alterations develop together with the progression of liver disease and may be considered as a prognostic markers for liver decompensation. the maneuvers concerned with the decline of lipid particles in patients with cirrhosis are compound and need multiple researches for complete understanding. protein microsomal triglyceride (tg) transfer protein -+ mtp\], enzymatic (acylcoa: cholesterol acyltransferase), and apoprotein (apo ai) reduction are considered to be linked to these changes. owing to the wide occurrence of liver disease in egypt, we made this study to assess lipid profile in cirrhotic patients and to evaluate its relation to the degree of cirrhosis.

Eligibility criteria:
inclusion criteria: * cirrhotic patients . exclusion criteria: * 1-patients with diabetes mellitus,malignancy,uremia. 2-patients with history of drugs for dyslipidemia. 3- patients presented with hepatocellular carcinoma 4- wilsons disease. 5-rheumatoid arthritis. 6- systemic lupus.

Keywords: cirrhosis, lipid profile
study of an ehealth delivery alternative for cancer genetic testing for hereditary predisposition in metastatic cancer patients

Conditions: Cancer

Summary: this study aims to determine if web-based ehealth delivery of pre-test and/or post-test counseling in cancer patients and/or those at risk for cancer can provide equal or improved cognitive and affective outcomes when compared to the standard of care delivery model.

cancer genetic testing has become a standard evidence-based practice, with established risk reduction and cancer screening guidelines for genetic carriers. with fda approval for parp inhibitors in patients with advanced breast, ovarian, pancreatic and prostate cancer, there is an additional therapeutic rationale for testing all breast, ovarian, pancreatic and prostate cancer patients for germline genetic mutations. yet, access to genetic specialists is limited in many area, and the traditional model of pre- and post-test counseling with a genetic professional will not support the rising indications for cancer genetic testing. thus, there is an urgent need to consider alternative delivery models to increase access and uptake of testing, while maintaining adequate patient outcomes. this study aims to assess if traditional pre-test (visit 1) and post-test (visit 2: disclosure) counseling delivered by a genetic counselor can be replaced with a self-directed web-based ehealth intervention to provide critical data to inform optimal ways to deliver cancer genetic testing in patients with breast, ovarian, pancreatic and prostate cancer, while maintaining quality of care and favorable cognitive, affective and behavioral outcomes. specific aim 1: to determine if web-based ehealth delivery of pre-test and/or post-test counseling can provide equal or improved cognitive and affective short-term and 6-month outcomes as compared to the two-visit standard of care delivery model with a genetic counselor. the investigator's primary outcomes will be changes in knowledge and anxiety. secondary outcomes will include uptake of testing, depression, cancer specific distress, uncertainty and health behaviors and provider time.

Eligibility criteria:
inclusion criteria: * 18 years of age or older * speak and understand english * male or female * a personal history of one or more of the following: * metastatic breast cancer * advanced ovarian cancer (stage iii-iv) * metastatic pancreatic cancer * metastatic prostate cancer * naive to previous cancer germline genetic testing exclusion criteria: * communication difficulties such as: * uncorrected or uncompensated hearing and/or vision impairment * uncorrected or uncompensated speech defects * uncontrolled psychiatric/mental condition or severe physical, neurological or cognitive deficits rendering individual unable to understand study goals and tasks
aminophylline in bradyasystolic cardiac arrest

Conditions: Cardiac Arrest

Summary: the purpose of this study is to evaluate the effect of aminophylline in patients with out-of-hospital bradyasystolic cardiac arrest.

out-of-hospital cardiac arrest treated by emergency medical services has an estimated incidence of 54.99 per 100,000 person years, which translates to some 155,000 episodes annually in the united states. bradyasystole is the first recorded rhythm in up to 52 percent of cardiac arrests, and many additional patients with an initial cardiac arrest rhythm of ventricular fibrillation deteriorate to bradyasystole after defibrillation efforts. survival to hospital discharge occurs in less than 3 percent of patients presenting with bradyasystole; however, due to its frequency, this rhythm accounts for over 17 percent of all cardiac arrest survivors. as a result, even a small improvement in survival from bradyasystolic cardiac arrest would result in thousands of lives saved annually. adenosine is an endogenous purine nucleoside that depresses the sinoatrial node, blocks atrioventricular conduction, inhibits the pacemaker activity of the his-purkinje system and attenuates the effects of catecholamines. since adenosine is produced and released by myocardial cells during ischemia and hypoxia, it may be a reversible factor in the etiology or perpetuation of bradyasystole. aminophylline is a competitive antagonist of adenosine. the use of aminophylline for bradycardia and heart block has been described, and a number of anecdotal reports and small studies have been published on the use of aminophylline in cardiac arrest. we undertook this study to evaluate the effect of aminophylline during cardiopulmonary resuscitation (cpr) of patients with out-of-hospital bradyasystolic cardiac arrest unresponsive to initial therapy.

Eligibility criteria:
inclusion criteria: * cardiac arrest * bradyasystole either as the presenting rhythm or as a rhythm developing during the course of the resuscitation * endotracheally intubated and ventilated with 100% oxygen * intravenous (iv) access established * bradyasystolic without palpable pulses after 1 mg of epinephrine and 3 mg of atropine. exclusion criteria: * a do-not-resuscitate directive * pregnancy * evidence of hemorrhage, trauma or hypothermia as a cause of the cardiac arrest * renal dialysis * theophylline hypersensitivity * patients taking an oral theophylline product * resuscitations directed by a paramedic student under practicum supervision

Keywords: heart arrest cardiopulmonary resuscitation aminophylline bradycardia humans emergency medical services
prospective, multicenter, non-randomized, single arm clinical trial to evaluate the safety and efficacy of e-ptfe grafts inner surface-treated with paclitaxel as an access for hemodialysis in patients with end-stage renal disease.

Conditions: Hemodialysis Access Failure

Summary: this prospective, multicenter, non-randomized, single-arm clinical trial aims to evaluate the safety and effectiveness of the use of paclitaxel-coated arteriovenous graft (avg) on the inner wall of eptfe graft, which is designed to reduce neointimal hyperplasia that causes stenosis and thrombosis after implantation of avg.

1. evaluation of safety primary outcome: all adverse events occurring in the subject 2. evaluation of effectiveness primary outcome: av graft primary patency secondary outcome: av graft secondary patency

Eligibility criteria:
inclusion criteria: * adult male or female between the ages of 20 and 80 * patients currently undergoing or scheduled for hemodialysis due to end-stage kidney disease. * patients who decided to receive avg procedure in forearm due to inability to perform autologous arteriovenous fistula (avf) * patients with a high risk of stenosis (neointimal hyperplasia) or thrombosis when artificial blood vessels were implanted exclusion criteria: * pregnant or lactating women * patients who are currently diagnosed with malignant tumors and are receiving chemotherapy or radiotherapy * patients with life expectancy less than 12 months * patients expected to receive a kidney transplant during the trial * patients with current or suspected infection * acute psychiatric problems require treatment * patients who have inserted a catheter into an artery or vein in their upper limb for avg procedure within the last 30 days * patients with coagulation disorder, platelet count \<50,000 / ul * patients with a neutrophil count of less than 1,500 cells / mm3 * patients judged to be unable to insert grafts by the operator

Keywords: hemodialysis vascular access arteriovenous graft paclitaxel-eluting graft