Kornimate/medical-research-clean huggingface dataset:
dexmedetomidine and propofol in the treatment of emergence agitation

Conditions: Emergence Agitation

Summary: 1. this clinical research aims to compare the effects of dexmedetomidine and propofol on the treatment of emergence agitation in adult patients after general anesthesia. 2. half of participants will receive dexmedetomidine while the other half will receive propofol when emergence agitation happens.

as a common problem observed in pediatric patients after sevoflurane anesthesia, emergence agitations are investigated mainly in children.for adults,previous studies were almost about the efficacy of premedication on preventing emergence agitation. once emergence agitation happens, there is still no guidelines established to recommend the medication usage in the post-anaesthesia care unit.so high-quality prospective clinical studies are required to provide evidence for emergence agitation treatment. dexmedetomidine and propofol are both widely used in general anesthesia and can be acquired easily.when emergence agitation occurs,both injections are common choices in daily clinical administration on emergence agitation.to the investigator's knowledge ,propofol with a very quick onset is superior for anesthesia goals, but is without analgesia effects.while dexmedetomidine can produce sedation,analgesia,anxiolysis.so the investigators propose the hypothesis here that dexmedetomidine is prior to propofol on the treatment of emergence agitation in adults patients after general anesthesia.therefore this research is undertaken to verify the hypothesis.

Eligibility criteria:
inclusion criteria: * adult patients aged 18-65 years old after general anesthesia * with informed consent provided. exclusion criteria: * age younger than 18 years or older than 65 years; * american society of anesthesiologists classification ≥ⅲ; * preoperative lung dysfunction(including pneumonia,atelectasis,adult respiratory distress syndrome,acute lung injury and so on); * preoperative heart dysfunction(including sever cardiac coronary disease,unstable angina,lvef≤30％，sick sinus syndrome，bradycardia:heart rate≤50bpm,second or third degree a-v block); * history of mental disease; * no informed consent provided; * uncontrolled hypertension(baseline blood pressure:sbp≥160mmhg or dbp≥110mmhg); * cancers; * enrolled in other researches within 90 days; * allergic to intervening medicine. * bmi less than 18 or more than 30 kg/m2.
a single arm phase 2 study of pemetrexed as 2nd-line treatment of advanced non-small cell lung cancer

Conditions: Carcinoma, Non-Small Cell Lung

Summary: in previous phase 2 studies, pemetrexed has shown antitumor activity in advanced non-small cell lung cancer as a single agent as well as in combination with cisplatin. since the introduction of vitamin supplementation, pemetrexed has shown good tolerance and high safety. vitamin supplementation has opened the opportunity to offer patients higher pemetrexed dosing, as has been demonstrated by a recent phase 1 study. the higher dose with supplementation may increase pemetrexed's efficacy without unduly compromising safety. the present phase 2 study will use pemetrexed dosing that is tailored to individual patient tolerance, and is an effort to determine the efficacy and safety of this approach in patients with advanced nsclc who had prior chemotherapy.


Eligibility criteria:
inclusion criteria: * diagnosis of nsclc * locally advanced or metastatic disease (stage iiib or iv). * patients must have previously received one chemotherapy regimen for palliative therapy of locally advanced or metastatic disease. * disease status must be that of measurable disease as defined by recist criteria * performance status of 0 to 1 on the eastern cooperative oncology group (ecog) scale; and adequate organ function. exclusion criteria: * known or suspected brain metastasis, or second primary malignancy that is clinically detectable at the time of consideration for study enrollment * concurrent administration of any other tumor therapy. * history of significant neurological or mental disorder, including seizures or dementia; or any other serious concomitant disorders that would compromise the safety of the patient or compromise the patient's ability to complete the study * inability to interrupt aspirin or other nonsteroidal anti-inflammatory drugs (nsaids) 2 days before, the day of, and 2 days after the dose of pemetrexed. * inability or unwillingness to take folic acid, vitamin b12 supplementation, or dexamethasone
inflammatory response in aortic valve replacement

Conditions: Inflammation; Systemic Inflammatory Response Syndrome; Thoracic Surgery; Aortic Valve Stenosis

Summary: the study investigates inflammatory and antiinflammatory response in patients with severe aortic valve stenosis needing either surgical treatment (surgical aortic valve replacement) or interventional cardiology treatment (transcatheter aortic valve implantation using the transfemoral access route or the transapical access route).

background surgical and interventional therapy for aortic valve stenosis exposes the patients to a immune reaction, which is different depending on the type of the treatment. in this study, the investigators would like to better understand the inflammatory and antiinflammatory response in this patient population by monitoring the perioperative cytokine response (interleukins), the human leukocyte antigen expression (hla-dr) and assessing soluble plasma factors (cd62l) involved in inflammatory processes. objective characterisation of inflammatory and antiinflammatory response in patients receiving aortic valve prosthesis selected for different treatment options. methods whole blood analysis at different time points (preoperatively, 4 / 24 /48 hours postoperatively) for different inflammatory and antiinflammatory markers: il-6, il-8, il-10, crp, tnf, soluble cd62l.

Eligibility criteria:
inclusion criteria: * written informed consent * severe aortic valve stenosis * surgical aortic valve replacement * transcatheter aortic valve implantation * no previous inflammatory condition exclusion criteria * missing informed consent * treatment with corticosteroids * treatment with antibiotics
the role of pulsed dye laser therapy in the management of burn scars

Conditions: Burn Scar

Summary: the purpose of this study is to determine the effects (good or bad) of pulsed dye laser treatment in burn scar height, texture, redness and pliability in acute burn injury.

while the literature tends to support the use of laser therapy in the management of burn scars, there is a definite lack of appropriately powered, randomized controlled trials. laser therapy can be quite expensive when compared to other treatment modalities for burn scars, and while promising, its true usefulness has yet to be conclusively demonstrated. for this reason, our research group is proposing the commencement of two randomized controlled trial pilot studies assessing the effects of pulsed dye laser (pdl) on burn scars. the objectives of this project will be to determine the effectiveness of pulsed dye laser therapy on burn scar vascularity, pliability, height and texture. it has been hypothesized that the pdl works on acute injury to decrease scar formation, and the fractional laser works on scar that is quiescent to promote remodelling. therefore the investigators are proposing to study both acute injury and late burn scars. this project will compare the effects of each laser type, and will either help support or refute the assertion that laser therapy can be used to improve burn scars. objectives: to determine the benefit of pulsed dye laser treatment in improving burn scar height, texture, vascularity and pliability in acute burn injury.

Eligibility criteria:
inclusion criteria: * burn scar * living in winnipeg * scar age one to 6 months * fitzpatrick i-iii skin type exclusion criteria: * open wound * active infection * previous scar treatment with steroid injection or interferon * established disposition towards keloid scarring

Keywords: burn scar laser
the effect of telerehabilitation of patients with duchenne muscular dystrophy

Conditions: Duchenne Muscular Dystrophy

Summary: the aim of this study is to investigate the effect of a telerehabilitation approach to patients with duchenne muscular dystrophy and evaluate patients' motor function, parents' anxiety and depression levels before and after the intervention


Eligibility criteria:
inclusion criteria: * patients with duchenne muscular dystrophy exclusion criteria: * patients without the ability of independent ambulation
a study on safety of tdcs one-shot in ucp

Conditions: Hemiplegic Cerebral Palsy

Summary: the study aims to evaluate the safety and the feasibility of transcranial direct current stimulation (tdcs) session in children and young adults with unilateral cerebral palsy (ucp). secondarily it aims to test the effects of tdcs (real vs sham) in improving, in very short term, upper limb (ul) functions.

unilateral cerebral palsy (ucp) represents the most frequent form of cp; the upper limb (ul) is generally more affected than the lower limb with an impact in "activity" and "participation" areas. the non-invasive brain stimulation techniques (nibs), such as transcranial direct current stimulation (tdcs), appear able to modulate neuronal plasticity processes even more late in age attracting great interest for their potential fallout in the field of rehabilitation. the effects of tdcs in recovery of motor function has more investigated in adults, while in the pediatric population studies on safety and efficacy are still few and not conclusive. this study aims to evaluate the safety and the feasibility of tdcs session in children and young adults with ucp both in short term and in follow up (up to 24 hrs after the tdcs session). secondarily it aims to test the effects of tdcs (real vs sham) in improving, in short term, ul functions. for the study 6 children (aged 10-17 years) and 6 young adults (aged 18-28 years) with ucp will be recruited. each subject receives, randomly, a real session and a sham session of tdcs with brainstim stimulator. before (t0), immediately after (t1) and after 1 hour and half (t2) to each tdcs session (real or sham) heart rate, blood pressure and ul functions will be measured. moreover the subject fills in an ad hoc questionnaire on safety at t1 and t2 and, on call, at 24 hours after the sessions (t3).

Eligibility criteria:
inclusion criteria: * symptomatic unilateral cerebral palsy * informed consent exclusion criteria: * any contraindication for tdcs

Keywords: unilateral cerebral palsy tdcs safety upper limb functions
group for trali study. semicyuc.

Conditions: Acute Lung Injury

Summary: objetives: 1. to research the worsening of respiratory status risk factors after transfusion in spanish critical care units. 2. to determine the incidence of transfusion-related acute lung injury (trali) in critically ill patients. 3. to research the morbi-mortality of trali.

actually there are no published european data on the incidence of acute lung injury by transfusion (trali) in critically ill patients, in europe, estimates of trali incidence are limited to passive reports of national blood banks. this multicenter study of spanish icus will investigate the incidence and trali predisposing factors (associated with the patient, the transfused blood product and the presence or absence of mechanical ventilation). design: prospective multicenter observational study. patients: all patients transfused in eleven spanish intensive care units (uci) from october 1, until november 30, 2010. patients with less of 18 years old, or transfused six hours before be included in this study or seriousness patients with a length of stay \<24 hrs will be excluded. variables: * patient data collection: demografic data (age, gender), clinical data (comorbid conditions), admission diagnostic , complications during the stay and severity of illness scores: acute physiology and chronic health evaluation (apache ii) score, sequential organ failure assessment (sofa) score, euroscore. * transfusion factors: type of blood product, time of infusion and volumen transfused, storage age and donor sex. * respiratory factors: main ventilation and oxigenation parameters and type of respiratory support before and after transfusion. for each transfusion episode was completed two data tables (see last page of the booklet of data collection): * before the transfusion (baseline) are listed the values of the patient's respiratory function, the analytical value that is transfused (hb, inr, aptt, pt, platelets) and the number of the bag that is transfused (to apply blood bank storage time and sex of the donor). * after the transfusion are recorded the volume and time infusion and 6 hours after transfusion are collected again the parameters of the patient's respiratory function and radiographic changes. according to official criteria shall be noted if the patient has exhibited a classic trali, possible trali, or a worsening of their respiratory function after transfusion.

Eligibility criteria:
inclusion criteria: * all patients transfused in eleven spanish intensive care units (uci) from october 1, until november 30, 2010. exclusion criteria: * patients with less of 18 years old, or transfused six hours before be included in this study or seriousness patients with a length of stay \<24 hrs will be excluded.

Keywords: transfusion, distress
effect of mgso4 on oxygenation and lung mechanics in morbidly obese patients during bariatric surgery

Conditions: Anesthesia

Summary: the purpose of this trial is to study the effect of mgso4 infusion on oxygenation and lung mechanics in morbidly obese patients undergoing bariatric surgery

background and objectives: morbidly obese patients are characterized by a high prevalence of restrictive lung disease. respiratory mechanics are significantly altered in obesity. these changes are exacerbated with general anesthesia .obesity also results in reduced lung and chest wall compliance ,increased lung resistance ,reduced oxygenation.mgso4 is promising in managing several respiratory disorders.it cause smooth muscle relaxation and reduce airflow obstruction. the objective of this trial is to study the effect of mgso4 infusion on oxygenation and lung mechanics in morbidly obese patients undergoing bariatric surgery. the following will be recorded :intraoperative oxygenation,lung mechanics,map,hr,etco2,plateau and peak airway pressure,sedation score,serum mgso4 level,change in p/f ratio and dynamic lung compliance,respiratory rate postoperative

Eligibility criteria:
inclusion criteria: * patients age between 21-60 years. * bmi more than 40kg/m2 * patients with restrictive lung disease(fvc\>70%) * american society of anesthesiologists(asa) physical status ii * no previous abdominal surgery * scheduled for laparoscopic bariatric surgery not exceeding 3 hours. exclusion criteria: * patient refusal to participate in the study * asa physical status more than ii * patients with heart failure * kidney disease * patients on antiarrhythmic drugs * patients taking beta or calcium channel blockers * allergy to study drugs * patients with combined restrictive-obstructive lung disease

Keywords: mgso4 oxygenation lung mechanics
prevalence of cachexia in patients undergoing chemotherapy

Conditions: Cancer; Cachexia

Summary: cachexia and low nutritional intake are a common phenomena in cancer patients undergoing chemotherapy. the purpose of this study is to assess prevalence of cachexia and low nutritional intake and the impact on quality of life, fatigue and mortality in patients undergoing chemotherapy. furthermore interactions between these parameters, tumor disease and chemotherapy, respectively.


Eligibility criteria:
inclusion criteria: * patients undergoing chemotherapy at least in the second cycle. * patients who have signed a written informed consent. exclusion criteria: * patients with implanted pacemaker or defibrillator.
early rehabilitation after hip fracture

Conditions: Accidental Falls; Fractures; Hip Fractures

Summary: the aim of this study is to compare a low versus high intensity physiotherapy early rehabilitation program combined with a low versus high dose vitamin d early rehabilitation program in a randomized controlled trial among elderly patients with acute hip fracture in an acute care setting. the primary outcome to be compared between treatment arms is the rate of falls during a 12-month follow-up. secondary outcomes are injurious falls, number of persons who fell, low-trauma fractures (at the hip, forearm, humerus, pelvis, ankle, spine, femur, tibia), disability, quality of life (euro-qol), mortality and health care utilization. another secondary outcome will be admission to nursing home compared between treatment arms among subjects, who are community-dwelling prior to the index hip fracture. admission to nursing home is the marker of loss of independence for the individual, but also triggers high cost for the society. the study will provide new early rehabilitation guidelines to allocate health care resources efficiently in the acute care setting. eventually and most importantly, the study will help improve outcomes in patients with hip fractures.

subjects: the researchers will enroll 204 elderly subjects (men and women) admitted to two large hospital centers with acute hip fracture. subjects may be institutionalized or community-dwelling prior to admission. to be enrolled in the study subjects need to be 65 years or older. demented persons, who reach a folstein mini mental status of less than 15 are excluded. design: once written informed consent from participants or proxies is given, subjects will be randomly assigned to 4 different program combinations based on a 2x2 factorial design: (1) low dose vitamin d / low intensity physiotherapy; or (2) low dose vitamin d / high intensity physiotherapy; or (3) high dose vitamin d / low intensity physiotherapy; or (4) high dose vitamin d / high intensity physiotherapy. low dose vitamin d is 800 iu cholecalciferol per day and high dose vitamin d is 2000 iu cholecalciferol per day. subjects will be recruited within 5 days after hip fracture surgery and followed for adverse outcomes over a 12-month period. dose of vitamin d will be double-blinded.

Eligibility criteria:
inclusion criteria: * age 65 years or older * acute hip fracture admitted to one hospital center exclusion criteria: * a folstein mini mental score of less than 15 as an indicator of significant dementia * primary hyperparathyroidism * current cancer with wasting or bone metastases * hyperparathyroidism * sarcoidosis * a kidney stone in the past 5 years or significant renal disease (creatinine clearance below 15 ml/min) * hypercalcemia (albumin adjusted) of more than 2.8 mmol/l * non-surgical treatment * no german language skills * severe hearing or visual impairment

Keywords: vitamin d elderly hip fracture falls physical therapy disability
comparing the efficacy of methylphenidate, dextroamphetamine and placebo in children diagnosed with adhd

Conditions: Attention Deficit Hyperactivity Disorder

Summary: the study compares the efficacy of methylphenidate, dextroamphetamine and placebo on neuropsychological functioning and behavioral symptoms in 36 children diagnosed with adhd within a double-blind cross-over design over six weeks. the assessment of adhd followed formalized guidelines and a diagnosis of adhd was based on dsm-iv criteria. a neuropsychological testbattery and four behavioral questionnaires were selected as efficacy variables. the neuropsychological testbattery includes qb-test (visual attention, inhibitory control, motor activity), score (auditory attention), stroop test (processing speed, inhibitory control) and grooved pegboard (motor speed). the participants were tested once on each type of medication. the four questionnaires are: a)side-effects rating scale (completed by a parent at the end of each of the six weeks), b)self-report questionnaire (completed by the child at the end of each of the six weeks), c)parent and teacher questionnaire(completed by a parent and a teacher monday till friday through every week), test performance questionnaire (completed by the child immediately after each of the three test sessions). main hypothesis: a trial including both dextroamphetamine(dex) and methylphenidate(met) will provide better results than a trial including only met. a)met and dex are efficient as treatment for adhd compared to placebo, albeit dex has moderately better effect compared to met. b)at an individual level some of the participants will show positive response to one type of stimulants and no response, mixed response or adverse response to the other type of stimulant. c)neuropsychological tests and behavioral questionnaires are moderately in agreement but also add unique information in the assessment of the effect of stimulants. d)qb-test is sensitive and valid as a measure of the effect of stimulants.


Eligibility criteria:
inclusion criteria: * age from 9.0 to 14.0. * adhd diagnosis following assessment at a child \& adolescent outpatient clinic. * clarification for stimulant treatment. exclusion criteria: * moderate or severe mental retardation. * psychosis. * proven brain damage. * sensory deficits and/or motor impairments that make the individual in question unsuitable for the relevant tests. * epilepsy. * the child has previously been prescribed stimulant medication or is being treated with such medication. * the child commutes between parents or there are other factors that substantially reduce the possibility of obtaining reliable observations from parents (the child needs to live in one place through out the whole trial since otherwise might severely influence the child's behaviour and the observations).

Keywords: adhd children methylphenidate dextroamphetamine placebo crossover double blind neuropsychological tests behavioural questionnaires