Kornimate/medical-research-clean huggingface dataset:
effect of early use of caffeine citrate in preterm neonates

Conditions: Preterm Birth

Summary: this work is designed to study the effect of the early use of caffeine citrate in preterm neonates who need respiratory support on morbidity and short term neonatal outcome.

caffeine citrate is one of the most widely used drugs in neonatal intensive care units. it is a respiratory stimulant which has well established therapeutic effects in apnea and facilitation of extubation. caffeine is an adenosine antagonist ; it blocks selectively a2 receptors and non selective blocks a1 receptors. its effects include improved lung compliance, minute ventilation, respiratory muscle contractility, increased sensitivity to carbon dioxide, enhanced catecholamine activity and decreased airway resistance early caffeine therapy was associated with a shorter duration of respiratory support and reduction in bronchopulmonary dysplasia , cerebral palsy, patent ductus arteriosis ligation, intracranial hemorrhage, apnea and death despite its widespread use, information regarding optimal time to initiate therapy and appropriate time to discontinue therapy is limited. recent studies have indicated that early initiation of caffeine therapy is associated with improved neonatal outcomes little is known about the early use of caffeine citrate in preterm neonates. the investigators aim to explore the effectiveness of its very early use in reducing the duration of respiratory support.

Eligibility criteria:
inclusion criteria: 1. preterm neonates ≤ 33 weeks gestational age. 2. preterm neonates who need respiratory support (either nasal canula, continuous positive airway pressure (cpap) or mechanical ventilation). exclusion criteria: 1. neonate\>33 wks gestational age. 2. neonates on room air. 3. neonates with major congenital or cardiac anomalies

Keywords: early caffeine preterm
an exploration of candidates for neoadjuvant treatment in resectable pancreatic cancer

Conditions: Pancreatic Cancer; Neoadjuvant

Summary: an exploration of candidates for neoadjuvant treatment in resectable pancreatic cancer

the 1,132 patients with resectable or borderline resectable pdac who underwent surgery between 2007 and 2021 were retrospectively reviewed. patients with resectable pdac without contact of major vessels (r-no contact) (n=651), with contact of portal vein or superior mesenteric vein (pv/smv) ≤180° (r-contact) (n=306), and borderline resectable pdac without arterial involvement (br-v) (n=175) were analyzed.

Eligibility criteria:
inclusion criteria: * patients diagnosed with resectable or borderline resectable pancreatic ductal adenocarcinoma (pdac) * between january 2007 and june 2021 at seoul national university hospital exclusion criteria: * patients who had borderline resectable pdac with arterial invasion * patients who received chemotherapy as initial treatment and did not undergo surgery * incomplete follow-up data for analysis
a comparison of optimal peep determination guided by eit and g5 device in moderate and severe ards patients

Conditions: Acute Respiratory Distress Syndrome

Summary: to select the optimal positive end-expiratory pressure in moderate and severe acute respiratory distress syndrome patients by using: 1. the novel non-invasive electrical impedance tomography guided method 2. the protective ventilation tool g5(mv)

1. to titrate peep guided by eit. a global inhomogeneity (gi) index and regional compliance based on eit were developed to quantify the tidal volume distribution within the lung. the aim of this study was to test the feasibility of optimizing peep with respect to ventilation homogeneity using the gi index and regional compliance. 2. to titrate peep with the protective ventilation tool by g5(mv). the new generation of ventilator will deliver an optimal peep on ards patients based on their status automatically.

Eligibility criteria:
inclusion criteria: 1. ards patients 2. transferred from femh emergency room or ward into the medical intensive care unit. 3. patients with invasive mechanical ventilation 4. patient, agent or consent of families learn about and subjects were willing to sign the consent form. exclusion criteria: 1. burning electric knife used 2. pacemaker used 3. large area wound is used gauze to cover 4. wound or burn injuries of the chest wall. 5. patients included conditions are not met.

Keywords: optimal positive end-expiratory pressure determination electrical impedance tomography
retrospective health care utilisation and current quality of life in adults with chronic otitis media who had a middle ear surgery

Conditions: Chronic Otitis Media

Summary: the objective of this multicentre study is to evaluate the standard of care of participants diagnosed with chronic otitis media that have already gone through a first middle ear surgery but still have at least a moderate hearing loss. the study has a retrospective part (extraction of medical chart data) and a prospective part with a survey and three questionnaires collecting data on the use of health care services, on health related quality of life and hearing performance.


Eligibility criteria:
inclusion criteria: * adult subjects, 18 years or older. * subjects with conductive or mixed hearing loss. * subjects with historically documented diagnosis of chronic otitis media (com) with or without cholesteatoma in the operated ear. * subjects who have undergone primary tympanoplasty type i-v to improve hearing between 2010-2016. * subjects with a pure tone average (pta)4 air-bone gap ≥30 decibels (db) or pta4 air-bone gap between 25-30 db with an air conduction threshold pta4 ≥40 db hl within 12 months after primary tympanoplasty in the operated ear. * subjects who have been recommended by their health care professional to try a hearing aid to improve hearing in the operated ear. * pre-op audiogram, maximum 1 year prior to the primary tympanoplasty, and post-op audiogram for the primary tympanoplasty are available. * aided audiogram, unaided if no hearing device is used, available between 2018 and the point of enrolment. * subjects are fluent in the language used for study questionnaires: german, french, spanish. * subjects are willing and able to provide written informed consent. for france: subjects do not oppose to participate in the study. * medical record data is available throughout the defined data search period, from primary tympanoplasty to point of enrolment. exclusion criteria: * subjects are unable or unwilling to comply with the requirements of the study as determined by the investigator. * investigator site personnel directly affiliated with this study and/or their immediate families; immediate family is defined as a spouse, parent, child, or sibling. * cochlear employees or employees of contract research organizations or contractors engaged by cochlear for the purposes of this study. for france only: * subjects who are not affiliated to social security. * subjects who are under legal protection.

Keywords: primary tympanoplasty
acupuncture therapy and hypertension

Conditions: Mild to Moderate Hypertension

Summary: acupuncture therapy will be provided to reduce blood pressure in hypertensive patients. the mild to moderate hypertensive patients will be either on or off hypertensive medications. the course last for 8 weeks and the frequency is once a week.

improvement in bp control rates would lead to one of the largest impacts in improving life expectancy and the quality of life for over 100 million people in the united states and 1 billion people worldwide with immediate and measurable results. in the united states, 80% of patients with htn are treated, but bp is controlled in only half of these individuals, with control worsening with increasing age. the reasons for inadequate treatment and bp control are complex, but one reason for this therapeutic misalignment may be an incomplete understanding of the mechanisms underlying the development and progression of htn. the aging process leads to dysfunction of the ans, resulting in neuroendocrine abnormalities and chronic low-grade inflammation. the investigators have previously shown that electroacupuncture (ea) at four targeted acupoints, can decrease sympathetic activity \[sympathoinhibitory (si)\], approaching levels close to those present prior to onset of htn and may address this unmet need in htn management. the investigators are now testing and have preliminary evidence that ea at two additional acupoints (sp6-7) increases parasympathetic activation, thereby decreasing circulating and tissue inflammatory biomarkers \[thus anti-inflammatory (ai)\] and when combined with si-ea can improve measures of vascular health including endothelial function and arterial stiffness in preclinical model with overall greater reduction in bp. together these combined six acupoints, when simultaneously activated by ea may restore optimal autonomic control of the immune system and target an important mechanistic pathway not addressed by bp-lowering pharmacotherapy alone. to date, 39 participants have been enrolled in the study.

Eligibility criteria:
inclusion criteria: 1. subjects from 45 to 75 years of age 2. clinically diagnosed with mild to moderate hypertension and on or off medication (office sbp \> 140 mmhg and \ 130 mmhg and \< 145 mmhg), and 3. no significant ecg change reflecting ischemia (i.e. st elevation or depression) at rest will be recruited to participate in this study. exclusion criteria: 1. subjects will be excluded if on anti-hypertensive medications. 2. subjects will be excluded if pregnant or nursing. 3. subjects will be excluded if they have coronary disease (by history or on ecg screening), conduction abnormalities on ecg consistent with left bundle branch block, cardiac arrhythmias associated with low blood pressure (\ 170 mmhg systolic or \>110 mmhg diastolic), or any other physical or psychological illness. 4. those with known sensitivity to any topical preparations or strong reactions to medical dressings and skin tapes also will be excluded. 5. inability our or unwillingness of individual to give written informed consent.

Keywords: hypertension, electroacupuncture
how exercise signals health responses

Conditions: Overweight

Summary: the purpose of this research is to determine the blood signals that promote health and well-being in response to exercise at different intensities.

most studies find a dose-response relationship between exercise participation and all-cause mortality. in contrast, physical inactivity and consequent overweight or obese status is associated with a cadre of health consequences. frequently, comorbidities of obesity are mechanistically linked via chronic low grade inflammation stemming from increases in adiposity. although exercise is known to combat obesity and obesity related disease states, the mechanisms of action are not fully understood. therefore, the investigators propose the following study in an attempt to elucidate anti- and pro-inflammatory endocrine responses to exercise. initial studies in animal models have provided evidence that exercise induces long-term anti-inflammatory effects, potentially via myokine signaling following skeletal muscle activation. humans are an ideal study population as the investigators can prescribe multiple exercise protocols that mimic human behavior, and control exercise intensity to meet recommendations. also, humans allow the investigators to collect larger plasma samples and therefore measure more circulating proteins of interest over multiple time-points. finally, the investigators can select individuals that exercise at different frequencies, allowing the investigators to analyze the differences in endocrine responses to exercise over differing levels of fitness. in summary, a human model will allow for a much better understanding of the human condition.

Eligibility criteria:
inclusion criteria: * no tobacco use * not pregnant, lactating, or planning to become pregnant in the next 6 months * regular menses for the past 6 months * no use of hormone replacement for metabolic conditions (use of hormonal contraceptives are not exclusionary) * no physical limitations * has the ability to safely perform exercise exclusion criteria: * has no major health problems * cannot have known cardiovascular (cardiac, peripheral vascular, cerebrovascular), pulmonary (copd, interstitial lung disease, cystic fibrosis) or metabolic (diabetes, thyroid disorders, renal or liver disease) disease
comparison of an opioid-free anesthesia protocol versus standard practices on early and late post-operative recovery

Conditions: Anesthesia; Anesthesia; Adverse Effect; Opioid Analgesic Adverse Reaction; Post-Op Complication

Summary: opioid-free anesthesia (ofa) is an anesthesia protocol that does not use morphine, and is increasingly used routinely. indeed, this protocol would theoretically allow a better post-operative analgesic control, a lower incidence of post-operative complications (e.g. post-operative nausea and vomiting). in the end, it would also allow a better overall post-operative recovery and a decrease in the incidence of chronic post-operative pain. nevertheless, the literature is poor on this issue and no randomized controlled study has evaluated the effect of the use of this type of anesthesia protocol on postoperative recovery.


Eligibility criteria:
inclusion criteria: * age \> 18 years * surgery lasting more than 90 minutes with planned use of morphine analgesics during post-operative hospitalization (outside the pacu stay), * ent surgery, plastic and reconstructive surgery, digestive and visceral surgery, urological surgery and gynecological surgery, * surgery that does not involve any bone procedure, * written consent of the patient, * french-speaking patient, able to understand and answer a questionnaire, * social security affiliation exclusion criteria: * pregnant, breastfeeding or parturient woman, * person deprived of liberty by judicial or administrative decision, * a person who is subject to a legal protection measure, * person unable to express consent, * bmi \ 39 kg/m2, * drug contraindications, in particular hypersensitivity to the active substances of one of the study drugs (in particular lidocaine hydrochloride or amide- or clonidine-linked local anaesthetics) or to one of the excipients, * porphyria, * heart failure or unstable coronary artery disease, * bradyarrhythmia due to sinus node disease or conduction clock, or adam-stock's syndrome, not fitted, * hepatocellular insufficiency with tp \< or =50%, * chronic renal failure with glomerular filtration \< 60 ml/min. * long-term treatment with imipraminics, neuroleptics, baclofen, and all other molecules at risk of qt prolongation, * uncontrolled epilepsy, * chronic treatment with beta-blockers, * need for induction in fast sequence, * severe psychiatric or cognitive disorder that interferes with the evaluation through questionnaires.

Keywords: anesthesia quality of recovery patient centered outcome
diarrheal adverse events in caucasian patients with idiopathic pulmonary fibrosis undergoing treatment with nintedanib

Conditions: IPF

Summary: the goal of this observational study is to to identify the demographic and clinical characteristics associated with the development of diarrheal adverse events in a caucasian population with ipf undergoing treatment with nintedanib. additionally this study aims to evaluate the different therapeutic strategies for dose reduction of nintedanib and assess the effectiveness of these strategies in reducing the occurrence of diarrhea.

the study population will consist of patients treated with nintedanib for ipf who are followed at the interstitial lung disease outpatient clinic of the pneumology and respiratory intensive care unit at the irccs azienda ospedaliero-universitaria of bologna, policlinico di sant'orsola, and who have received the treatment for at least 12 consecutive months. at the first available visit (which will be conducted according to the routine follow-up schedule), informed consent for participation in the study will be obtained. following the signing of the informed consent, the data of interest for the protocol will be collected retrospectively, concerning the visit at which nintedanib therapy was initiated and the follow-up visits conducted at 6 and 12 months from the start of the antifibrotic therapy, as per clinical practice.

Eligibility criteria:
inclusion criteria: * caucasian ethnicity; * age ≥ 18 years; * subjects with a diagnosis of ipf who started antifibrotic therapy with nintedanib on or after 01/06/2020. * obtaining written informed consent exclusion criteria: * clinical and functional data not availbale

Keywords: ipf
effect of isoflurane on tissue doppler imaging of mitral annulus during cardiac surgery

Conditions: Valvular Heart Disease; Ischemic Heart Disease

Summary: the purpose of this study is to determine isoflurane's dose-dependent effect on left ventricular (lv) systolic function in cardiac surgery. the change of tissue doppler imaging (tdi) of lateral mitral valve annular systolic velocity at three different isoflurane concentrations would be analyzed by using intraoperative transesophageal echocardiography (tee) in cardiac surgery patients.

isoflurane is widely used in cardiac surgery patients due to its beneficial effects, but many studies have shown that isoflurane reduces myocardial contractility in a dose-dependent manner, and compromises left ventricular (lv) function. tissue doppler imaging (tdi) of mitral annular velocity during the cardiac cycle has been introduced as a reliable method for analysis of systolic and diastolic lv long-axis function. efficacy of systolic and diastolic tdi profiles, including systole (s'), early early relaxation (e')and atrial contraction (a') have been suggested to be useful in predicting the impact of isoflurane on lv systolic and diastolic function. the investigators hypothesized that isoflurane, even at a clinical dosage, would affects intraoperative lv systolic function in a dose-dependent manner and thus produce significant changes int the tdi profiles of systolic mitral annular velocity (s'). so the investigators planned to study the changes in s' of lateral mitral annulus at the clinical isoflurane dosage during remifentanil based anesthesia for cardiac surgery.

Eligibility criteria:
inclusion criteria: * patients undergoing cardiac surgery exclusion criteria: * low ejection fraction \< 50% in preoperative transthoracic echocardiography * atrial fibrillation * pacemaker * pericardial and infiltrative myocardial disease * mitral annular calcification, surgical rings, prosthetic mitral valves * lateral left ventricular regional wall motion abnormality * esophageal spasm, stricture, laceration, perforation, and diverticulum diaphragmatic hernia * history of extensive radiation to mediastinum * upper gastrointestinal bleeding

Keywords: isoflurane mitral valve annular velocity tissue doppler imaging monitoring echocardiography
comparative effect of art and met on pain, rom and functional disability in ac patients with trigger points

Conditions: Adhesive Capsulitis

Summary: the aim of this study to determine the comparative effect of active release technique and muscle energy technique on pain, rom and functional disability in adhesive capsulitis patients with trigger points.

74 participants are included in this study in two groups and 37 for each group. group a for active release technique along with conventional therapy and group b for muscles energy technique along with conventional therapy.

Eligibility criteria:
inclusion criteria: * both male and female. * participants having unilateral adhesive capsulitis. * participants with sub-acute adhesive capsulitis. * participants having age of 40-60 years. exclusion criteria: * patient with cervical radiculopathy. * fractures of upper limb. * thoracic outlet syndrome. * post-traumatic.

Keywords: adhesive capsulitis trigger points active release technique muscle energy technique
study of metabolic changes in the transformation malignant precancerous skin lesions

Conditions: Cutaneous Squamous Cell Carcinoma; Basal Cell Carcinomas

Summary: skin carcinomas are the most frequent cancers in the world, including basal cell carcinomas and cutaneous squamous cell carcinoma (csccs), with more than 60.000 new annual cases in france. their incidence increases mainly due to ultraviolet (uv) exposure and population ageing. then from 1994 to 2006, the incidence of cscc has increased by 300%. csccs typically manifests as a spectrum from a precursor actinic keratosis (ak) - possible spontaneous regression at this stage- to in situ cscc invasive cscc and finally metastatic cscc.

although growing evidence indicates that bioenergetic metabolism plays an important role in the progression of tumorigenesis, little information is available on the contribution of reprogramming of energy metabolism in cancer initiation and how it influences further the bioenergetic behavior of tumors. by applying a quantitative proteomic approach, the consortium has recently found that specific metabolic modifications precede cscc. this study will investigate the role of energy metabolism in malignant transformation of premalignant skin lesions into cscc, and in cscc progression, with correlation with clinical characteristics and metastatic outcomes. using several cutting-edge technologies in human samples, the team will evaluate whether targeting energy metabolism has the potential to be used as curative treatments for cscc and whether pre-determined metabolic alterations could be exploited as new preventive strategies. these modifications in energy metabolism could be used as prognostic and diagnostic biomarkers.

Eligibility criteria:
inclusion criteria: * every patient with suspected lesion : * ak, * in situ cscc, * infiltrative cssc * cscc with recurrent disease * cscc with cutaneous metastases. * patients 18 years of age or older, * patients with suspected ak or bcc lesions (in situ, infiltrating or metastatic), * patient able to sign a consent form, * patient affiliated with a social security system. exclusion criteria: * prior systemic treatment such as checkpoint inhibitors or chemotherapy. * patients with cscc or ak localized on visible zone of the face or folds

Keywords: actinic keratosis mitochondria metabolism