Kornimate/medical-research-clean huggingface dataset:
intranasal hydromorphone for the treatment of acute pain in children: a pilot study.

Conditions: Pain

Summary: intranasal hydromorphone has been shown to be effective in reducing acute pain in adults. it has not been previously studied in children, but may be a viable option for effectively and safely reducing pain in children by administering an analgesic by the intranasal route. this study will be a prospective, open-label pilot study of intranasal hydromorphone in children with moderate to severe acute pain presenting to the pediatric emergency department. the investigators aim to describe the amount of pain reduction associated with intranasal hydromorphone, and to determine the optimal dose of intranasal hydromorphone associated with a clinically meaningful improvement in acute pain.

primary aim: determine the change in pain intensity in children with moderate to severe pain who receive intranasal hydromorphone one hour after administration. secondary aim(s): describe the incidence of minor and major adverse events associated with intranasal hydromorphone in children with acute pain. the investigators will assess the patient's pain at baseline (prior to study drug administration), then after study drug administration: 5 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes, and then every 30 minutes thereafter until 6 hours; administration of non-protocolized rescue medication administration (i.e. administered after first two rescue doses of in hydromorphone); or discharge from emergency department (whichever comes first). the pain score at 60 minutes will be the primary outcome. the investigators will evaluate qualitative improvement in pain intensity at 15- and 30-minutes after study drug administration. if there is no improvement, or worsening of pain intensity, at each assessment, an additional rescue dose rescue dose of intranasal hydromorphone will be administered. after 60 minutes, the treating physician may administer any additional rescue medications at their discretion to treat the child's pain. the patient will be assessed for minor and major adverse events for the duration of the study.

Eligibility criteria:
inclusion criteria: * age 4 to 17 years old, inclusive * moderate to severe pain (i.e. fps-r or vnrs score of 4 or more) * requires parenteral opioid analgesic to treat their pain, as decided by treating physician exclusion criteria: * allergy or known contraindication to receiving opioids * receipt of any opioid or benzodiazepine within preceding 6 hours * presence of intranasal obstruction that cannot be cleared readily * cannot speak english or spanish * patient unlikely to be able to complete self-report measures of pain or questionnaires * known liver or kidney problems * currently critically ill * chronic pain condition (e.g. sickle cell disease, fibromyalgia)

Keywords: intranasal hydromorphone pediatric emergency department
does rpni reduce incidence of neuroma formation following sural nerve biopsy

Conditions: Neuroma of Lower Limb

Summary: the purpose of our project is to determine if incorporating preventative surgical techniques such as regenerative peripheral nerve interfaces (rpni) into sural nerve biopsy can reduce the incidence of symptomatic neuroma formation. findings from this study will inform best practice guidelines and can dramatically impact patient care, improve patient quality of life, and reduce the number of required repeat operations.

neuromas are a known complication from traumatic injury or surgery, including nerve biopsies. neuromas are formed by non-neoplastic aberrant proliferation of injured nerves that cannot innervate an end target resulting in a neuroma bulb made of free nerve ends, fibrotic tissue, and blood vessels. neuromas can cause significant, debilitating pain resulting in decreased quality of life for patients and potential repeat operative interventions. the incidence rate of neuroma formation following injury is not well described but previous literature reports rates up to 30% with 14% of patients requiring repeat operation. in order to address this problem, numerous preventative and therapeutic measures have been explored. nonsurgical management options such as desensitization, anesthetic and/or steroid injections, analgesia, and nerve stimulation have yielded mixed results.10 therefore there is a need for reproducible and reliable prevention and treatment strategies for painful neuroma. currently, the main surgical interventions consist of targeted muscle reinnervation (tmr) and regenerative peripheral nerve interface (rpni). in tmr, free nerve ends are transferred onto recipient motor nerves, whereas in rpni, free nerve ends are wrapped in a free muscle graft. both methods provide denervated muscle targets for nerve ends. compared to tmr, and other microsurgical measures such as primary repair or nerve grafting, rpni is a much simpler operation that can easily be performed in the minor procedures or ward setting where nerve biopsies are usually completed. given the functional impact from painful neuromas and subsequent burden on operative resources, efforts should be taken to prevent neuroma formation with rpni at time of biopsy. our project could directly improve patient care by substantiating the need for preventative measures for neuroma formation during for sural nerve biopsy thereby changing the standard of care. given the significant pain, decreased quality of life, and need for repeat interventions, incorporating rpni could have dramatic impacts on patient care and reduce operative and resources burdens.

Eligibility criteria:
inclusion criteria: * patient 18 years old and older who are referred for sural nerve and muscle biopsy to the university of british columbia division of plastic surgery from january 2025 onwards for diagnostic or prognostic clarification of a medical condition. exclusion criteria: * patients with previous nerve trauma (traumatic injury, surgery, or repeat biopsy) of biopsied nerve.

Keywords: sural nerve biopsy regenerative peripheral nerve biopsy rpni
an analysis of the efficacy of high dose isofosfamide through elastomer

Conditions: Osteosarcoma Recurrent

Summary: a multicentre, observational, retrospective study to analyse the efficacy of high dose isofosfamide thorugh elastomer in patients with relapsed/ refractory osteosarcoma


Eligibility criteria:
inclusion criteria: * diagnosis of high risk relapsed/ refractory osteosarcoma * aged \<= 40 years at the beginning of treatment * at least one completed cycle of hd ifo through elastomer (14g/mq) in 14 days * disease evaluation according to recist criteria v.1.1 exclusion criteria: * none
internet-delivered cbt for irritable bowel syndrome in adolescents

Conditions: Irritable Bowel Syndrome; Functional Gastrointestinal Disorders

Summary: this randomized controlled trial aims to evaluate the treatment effects of an internet-delivered cbt-program for adolescents with irritable bowel syndrome.

irritable bowel syndrome (ibs) is prevalent and associated with low quality of life in adolescents. medical or dietary treatments lack evident efficiency, while psychosocial interventions, i.e. cognitive behavior therapy (cbt)has shown promising effects in face-to-face treatments. therapists trained to deliver cbt for ibs are scarce, leading to a situation where very few adolescents with ibs receive the only evidence-based intervention. exposure-based internet-delivered cbt (icbt) for adults with ibs has shown strong stable effects and cost-efficency. our aim is to develop a treatment that enhances the availability to evidence-based treatment for children and adolescents with ibs. such a treatment could swiftly be implemented in regular health care for this large population. the main purpose of this study is to compare the effectiveness of exposure-based icbt to treatment as usual (wait-list) for adolescents with ibs.

Eligibility criteria:
inclusion criteria: * age 13-17 at inclusion date. * fulfilling rome iii-criteria for ibs with a written statement from patient's physician confirming a diagnosis of ibs and negative required tests (blood samples: c-reactive protein or erythrocyte sedimentation rate, blood count and iga-transglutaminase. stool: f-calprotectin). exclusion criteria: * concurrent serious medical conditions. * a psychiatric diagnosis, judged to be a more important treatment target than the abdominal pain. * on-going psychological treatment. * absence from school exceeding an average of 2 days a week is a cause for exclusion since high absence demands more intensive interventions than can be offered in icbt. * on-going abuse or severe parental psychiatric illness in the family. * since treatment format assumes normal reading and writing skills, pronounced language skill deficits and learning difficulties lead to exclusion from the study. * lack of regular internet-access.

Keywords: icbt ibs fgid functional abdominal pain adolescents children treatment cbt exposure cognitive behavior therapy internet computerized abdominal pain functional pain functional disorders
visual pain score and perfusion index in postoperative patients

Conditions: Perfusion

Summary: the relationship between visual pain score and perfusion index in postoperative patients.

the patients' operated with general anesthesia and who had visual pain score(vas) above 3 will be measured postoperatively perfusion index. .if the vas score is above 3, 2 mg of morphine will be made. when the vas score is below 3, the perfusion index will be measured again.thus, the changes between vas and perfusion index will be measured.

Eligibility criteria:
inclusion criteria: * patients who underwent surgery with general anesthesia exclusion criteria: * patients with caesarean section, pregnancy story and chronic pain
emergency call for heart attack and stroke (echas) - echas one study

Conditions: Heart Attack and Stroke

Summary: echas one will test the use of a smartphone app to assist patients to decide if it is necessary to call for emergency care with symptoms that could represent a heart attack or stroke.

the echas one study will be conducted in 200 patients who have already called for emergency care for a heart or stroke, and have been evaluated. the endpoint of the study will be a decision if the initial call was an appropriate call for emergency care. the sensitivity of the app for detecting appropriate calls will be assessed.

Eligibility criteria:
inclusion criteria: * presented to ed via emergency medical services (ems) for "stroke alert" symptoms, including: slurred speech asymmetric weakness or numbness balance problems vision changes headache and/or "mi alert" symptoms including: chest discomfort chest pressure or pain palpitations shortness of breath lightheadedness or presyncope syncope age ≥ 18 years able to provide informed consent exclusion criteria: * non-english speaking * moderate or greater dementia * severe visual impairment * inability to use smartphone (for physical, cognitive, or other reasons) * unable to consent for study

Keywords: triage smartphone
the effect of marijuana and prescription medications in mood, performance and sleep

Conditions: Marijuana Dependence

Summary: heavy marijuana users report experiencing trouble sleeping when they try to quit, but this has not been carefully studied. this research is being done to learn more about sleep function in heavy marijuana users, and to determine whether a medication approved for treating insomnia can help restore normal sleep function during brief periods of abstinence.


Eligibility criteria:
inclusion criteria: * current use of marijuana * able to give informed consent exclusion criteria: * dependence on drug other than marijuana * current sleep disorder * pregnant, breast feeding, or planning to become pregnant within the next 3 months * currently seeking treatment for cannabis-related problems or otherwise trying to reduce use * use of cannabis under the guidance of a physician for a medical disorder * unstable or uncontrolled cardiovascular disease (e.g., hypertension, angina) * allergy to study medication

Keywords: marijuana cannabis dependence withdrawal
role of neuronal guidance proteins as diagnostic markers for acute kidney injury (aki)

Conditions: Acute Kidney Injury

Summary: acute kidney failure remains one of the most challenging entities to diagnose in clinical medicine, especially in the field of intensive care. the diagnosis of acute kidney injury is based solely on urine output and serum creatinine, both of which could also be influenced by other factors. a more sensitive and faster diagnostic option would not only be desirable but of utmost clinical importance. therefore, the investigators aim to identify neuronal guidance proteins (ngps) as potential biomarkers for the identification and early detection of aki with this investigation. this investigation aims to identify the possibility of diagnosing acute kidney injury, the subsequent validation of a potential biomarker will then have to take place in a multicenter study approach: data in preclinical mouse models suggest that sema7a as one of the ngps could be valuable as a biomarker, the study now aims to attempt a preliminary survey in humans and measure various ngps.


Eligibility criteria:
inclusion criteria: * patients undergoing cardiac surgery * written consent exclusion criteria: * no written consent possible * polytrauma, severe burns * immunosuppression * pregnancy * diagnosis of hepatitis b, hepatitis c, and/or hiv * sepsis * pre-existing kidney damage

Keywords: neuronal guidance protein acute kidney injury
french national registry of rare peritoneal surface malignancies

Conditions: Rare Peritoneal Surface Malignancies; Pseudomyxoma Peritonei; Peritoneal Mesothelioma; Desmoplastic Small Round Cell Tumor; Psammocarcinoma; Primary Peritoneal Serous Carcinoma; Diffuse Peritoneal Leiomyomatosis; Appendiceal Mucinous Neoplasms

Summary: despite advances in the management of and changes in clinical practice, little is known about the epidemiology, patterns of care and outcomes of rare peritoneal surface malignancies patients in france. in order to better understand the characteristics of rare peritoneal surface malignancies and to evaluate treatment strategies, the renape registry aims at the collection of data from patients presenting with a rare peritoneal surface malignancy in france. data will be entered prospectively in a specifically designed and secured web database. all renape's centres and physicians are invited to register patients with a rare peritoneal surface malignancy diagnosis and to participate to the registry. data will be evaluated within regular time frames, focusing on types of rare peritoneal surface malignancies, treatment modalities and patient outcomes (e.g. survival, recurrence), thereby contributing to the better understanding of these rare cancers.


Eligibility criteria:
inclusion criteria: * patients are eligible if they have a histologically proven rare peritoneal surface malignancy. exclusion criteria: * histological diagnostic of peritoneal surface malignancy not confirmed * expected clinical follow up data not available

Keywords: rare peritoneal surface malignancies pseudomyxoma peritonei peritoneal mesothelioma desmoplastic small round cell tumor psammocarcinoma primary peritoneal serous carcinoma diffuse peritoneal leiomyomatosis appendiceal mucinous neoplasms registry population-based database
seroimmunity 2007 and sub study of the swedish population regarding vaccine preventable disease

Conditions: Diphtheria; Tetanus; Pertussis; Polio; Haemophilus Influenzae Type B; Measles; Mumps; Rubella; Hepatitis B

Summary: this is a randomized cross-sectional study of the swedish population. blood samples will be collected from a subpopulation in order to estimate the age specific sero-prevalence of the swedish population for diseases included in the national immunization program (nip), and to affirm the population's protection against polio. to be able to recommend complementary immunizations to immigrated children, a sub study focusing on foreign born teenagers will also be done and compared to children of the same age born in sweden.

besides the main objectives stated in the summary, the study consists of: vaccine related objectives: * to estimate the seroprevalence regarding vaccine preventable diseases in the cohort of children about to enter adulthood (as a "receipt" of the vaccination program's functionality), and thereby form a basis for decision-making regarding recommendations about continuous vaccination in adult age * to evaluate the concentration of antibodies that full-term newborns receive from their mothers, and to estimate plausible consequences to optimize the schedule of the nip for each vaccine preventable disease * to, in different age groups, evaluate changes over time and concentration of antibodies compared to a study conducted in 1997 * to evaluate plausible changes in the seroprevalence, for instance among children, related to an increased use of combined vaccines * to document the age-specific seroprevalence against other diseases that will be vaccine preventable before start-up of new vaccination program * to estimate the population seroprevalence against certain diseases against which vaccines have been developed during recent years and that might be introduced into the vaccination program within a couple of decades method: * adults: one blood sample of 10 ml blood from vein in arm from each individual * children: one blood sample of 5-10 ml blood from vein or capillary in arm from each individual * cord blood: one blood sample of 10 ml cord blood will be collected from each newborn in connection with childbirth the objectives of the sub study are: * to conduct the same type of analysis on foreign born 14-16 year olds as on 14-16 year olds being born in sweden * to also examine the immunity and infection situation with regard to hepatitis b * to conduct the corresponding examinations and priorities among the 14-16 year olds born in sweden serving as control group

Eligibility criteria:
inclusion criteria: * informed written consent (both groups) * immigrated to sweden after 6 years of age from a country with polio vaccination coverage \< 85 % (sub study group) * living and attending school in stockholm, gothenburg or malmoe (sub study group)

Keywords: diphtheria tetanus pertussis polio haemophilus influenzae type b hib measles mumps rubella hepatitis b vaccine vaccination immunity vaccination program sweden elisa
indomethacin for refractory chronic cough

Conditions: Refractory Chronic Cough

Summary: chronic cough is a common complain of patients in respiratory clinic and its global prevalence was up to 9.6%. persistent cough of unexplained origin is a significant health issue that occurs in up to 5% to 10% of patients seeking medical assistance for a chronic cough and from 0% to 46% of patients referred to specialty cough clinics. previous studies showed that sputum prostaglandin d2( pgd2) and prostaglandin e2 (pge2) concentrations were significantly higher in chronic cough. and some research showed that inhaled pge2 /pgf2α /pgd2 / pgi2/ 6-oxo-pgf1a could induced cough. and pge2 /pgf2α/pgi2/thromboxane a2 (txa2) also increased the sensitivity of the cough reflex. all these five primary prostaglandins were synthesized though the metabolism of arachidonic acid via the cyclooxygenase pathway. indomethacin is a strong inhibitor of cyclooxygenase , which decrease the level of prostaglandins in airway. the investigator's preliminary study showed that indomethacin could relieve cough and improve cough sensitivity of some patients with refractory cough. therefore this randomized, double-blind, placebo-controlled trial were designed to investigate whether indomethacin can relive cough in patients with refractory cough and to explore the possible mechanism of indomethacin in improving cough in patients with refractory cough.


Eligibility criteria:
inclusion criteria: 1）18 years old ≤ age ≤ 60 years old, male or female; 2）chronic cough lasting more than 8 weeks as the sole or predominant symptom, without abnormalities on chest radiograph; 3）chronic cough remains after investigation and supervised therapeutic trial(s) conducted according to "clinical practice guidelines for diagnosis and management of cough (2015)" 4）cough vas (0-100mm) ≥ 30 mm exclusion criteria: 1. patients had any contraindications to indomethacin; 2. patients had active respiratory disease (such as chronic obstructive pulmonary disease or untreated asthma), or moderate or above obstructive or restrictive or mixed pulmonary ventilation dysfunction; 3. patients had a respiratory tract infection in the month before randomization; 4. patients were taking an angiotensin-converting enzyme inhibitor; 5. patient were pregnant or breastfeeding, or had impaired kidney function; 6. current and recent smokers (\<6 months' abstinence), or ex-smokers with more than 20 pack-years (20 cigarettes per pack).
school-based physical activity intervention for obesity among adolescents with intellectual disability in hong kong

Conditions: Obesity

Summary: considering that children with intellectual disability (id) might be more vulnerable to obesity than their counterparts in the general population. this study aimed to develop and evaluate the effectiveness of an adapted physical activity (apa) program in reducing weight among adolescents with id. the hypothesis of the study was the apa program would be able to decrease obesity among adolescents with id.

background: children with intellectual disability (id) might be more vulnerable to obesity than their counterparts in the general population. this study aimed to evaluate the effectiveness of an adapted physical activity (apa) program in reducing weight among adolescents with id. methods: a 9-month randomized controlled trial of a school-based apa program was conducted in adolescents with id and overweight/obesity in hong kong. the intervention group received the apa program which consisted of endurance and strength-building exercises at a frequency of two sessions per week, while the control group received routine pe classes as usual. data on obesity-related variables were collected before the intervention, at the midpoint of the intervention and after the intervention. linear mixed-effect models were used to examine the intervention effects.

Eligibility criteria:
inclusion criteria: * aged between 12 and 18 years * overweight and obesity * mild or moderate intellectual disability exclusion criteria: * physical disability * medical predispositions towards obesity (genetic syndrome or drug treatment) * contraindications (e.g. asthma, heart disease) * having participated in other exercise programs in the past 6 months.

Keywords: adolescents intellectual disability overweight obesity physical activity intervention