Kornimate/medical-research-clean huggingface dataset:
pecto-intercostal fascial block vs. transversus thoracic muscle plane block in cardiac surgery

Conditions: Pain, Postoperative; Coronary Artery Disease

Summary: in patients undergoing open cardiac surgery, pain control is an essential part of the enhanced recovery process. the current study aimed to evaluate the analgesic efficacies of ultrasound-guided pecto-intercostal fascial block and ultrasound-guided transversus thoracic muscle plane block for open cardiac surgeries. analgesic efficacy will be assessed on the numeric rating scale (nrs) along with intraoperative and 24 h postoperative opioid consumption.

it has been reported that the ttmp block and pif block produce effective postoperative analgesia for open cardiac surgeries. the hypothesis of our study; pif block reduces pain and analgesic consumption in the acute period (0-24 hours) similar to ttp block in patients undergoing elective cardiac surgery requiring median sternotomy. patients will be divided into two groups: group pifb: a bilateral pif block will be performed intraoperatively (20 ml, %0.25 bupivacaine + 1:400.000 adrenaline). in addition, iv morphine patient-controlled analgesia (pca) will be applied postoperatively for 24 hours. group ttmpb: a bilateral ttmp block will be performed intraoperatively (20 ml, %0.25 bupivacaine + 1:400.000 adrenaline). in addition, iv morphine-pca will be applied postoperatively for 24 hours.

Eligibility criteria:
inclusion criteria: * asa 1-3 patients between the ages of 18-80 who are scheduled for elective cardiac surgery (coronary artery bypass graft surgery with median sternotomy +/- valve replacement or isolated valve surgery) * bmi \<35 kg / m2 exclusion criteria: * emergent surgeries, redo cases, minimally invasive procedures * patients who do not want to participate * patients with cognitive dysfunction (patients who are not able to evaluate the verbal numerical pain scale) * hypersensitivity or history of allergies to local anesthetics * patients with severe major organ dysfunction (such as renal or hepatic insufficiency) * lvef \<30 * patients with psychiatric disorders * pregnancy or breastfeeding * presence of hematological disease * patients with alcohol-drug addiction * patients who use daily opioids for any reason

Keywords: pain, postoperative surgery, cardiac nerve, block
ecg belt vs. echocardiographic optimization of crt

Conditions: Heart Failure, Systolic

Summary: cardiac resynchronization therapy (crt) has been a valuable intervention for patients with systolic heart failure for over 15 years. despite years of research, there is a still a 25-40% non-responder rate depending on the outcomes measured. crt optimization is a term used to describe the act of individualizing the therapy (crt programming) for an individual patient. this is not often performed, but when it is, echocardiography is utilized. recent work of body surface mapping using a novel system called the ecg belt has shown a relationship between measures of electrical dyssynchrony and acute and chronic heart pumping function. this study will compare outcomes of patients randomized to either echocardiographic or ecg belt optimization of crt devices.

this is a prospective randomized study designed to determine whether cardiac resynchronization therapy (crt) device programming guided by the ecg belt (medtronic, plc) improves echocardiographic and functional outcomes in heart failure (hf) patients. the population will include patients treated with crt for standard indications (not implanted for the sole purposes of this study). the study will focus enrollment on patients who do not have baseline characteristics predicting the best crt response. therefore the study will not enroll patients having non-ischemic hf etiology, left bundle branch (lbbb) morphology, and qrsd \> 150 ms or those previously rv paced.

Eligibility criteria:
inclusion criteria: * willing and able to provide informed consent for participation in the study * age ≥18 years * received a first-time crt device for standard clinical indication (can be upgraded from non-crt pacemaker or defibrillator if ventricular pacing \< 10%) * adequate echocardiographic images for ef \& lvesv determination exclusion criteria: * unhealed open wounds on the torso and/or a history of documented severe allergic reactions from ecg electrode gel * enrollment in a concurrent study that could confound the results of this study * pregnant or could become pregnant within the 6 month follow-up period * non-ischemic cardiomyopathy, lbbb morphology, and qrsd \> 150 ms * dysrhythmia (af or pvcs) that will likely result in aggregate ventricular pacing \< 90% over the 6 month follow-up period

Keywords: cardiac resynchronization therapy pacing echocardiography optimization heart failure
aneurysm embolization system for intracranial aneurysms

Conditions: Ruptured Cerebral Aneurysm

Summary: the purpose of this clinical study was to evaluate the safety and efficacy of the aneurysm embolization system produced by jiangsu changyida medical technology co., ltd. in patients with intracranial aneurysms (including ruptured aneurysms)


Eligibility criteria:
inclusion criteria: * (1) age ≥18 years old, and ≤75 years old, male or female; (2) there was an unruptured aneurysm or a single ruptured aneurysm requiring treatment, and the hunt-hess score was grade i-iii; (3) the target aneurysm to be treated must have the following characteristics: 1. sacculate; 2. aneurysms located in anterior communicating artery, middle cerebral artery bifurcation aneurysms and basilar artery apex aneurysms; 3. the diameter of the aneurysm is in accordance with the instruction manual of the aneurysm embolization system for treatment; 4. aneurysm diameter from 2mm to 15mm; 5. tumor body/neck (d/n) ratio ≥1; 6. tumor neck ≥4mm or tumor body/neck (d/n) ratio \< 2; (4) the target aneurysm is suitable for aneurysm embolization system treatment; (5) the subject is able to understand the purpose of the study, demonstrates sufficient adherence to the study protocol, and is able and willing to sign the informed consent. exclusion criteria: * (1) patients with aneurysms who are not suitable for endovascular therapy; (2) the microcatheter could not reach the target aneurysm of the patient after being shaped, and could not be treated with research instruments; (3) there are risk factors for ischemic stroke, or ischemic symptoms that have occurred within the last 30 days, such as transient ischemic attack, minor stroke, or progressive stroke; (4) the presence of cerebrovascular, cardiovascular or neurological diseases that cause instability of neurological symptoms; (5) mrs≥ 2 before the onset of symptoms or rupture of the aneurysm (if applicable); (6) patients with intracranial hypertension or other intracranial hematoma within 90 days requiring elective surgery; (7) patients who are being treated with anticoagulants or who currently have malignant diseases of the blood system, coagulation diseases or hemoglobinopathy; (8) patients who are allergic to any component of the research instrument, surgical material or drugs used during the operation and cannot be effectively treated; (9) patients whose life expectancy is less than 2 years due to other diseases or conditions (other than intracranial aneurysms); (10) patients with mental disorders; (11) women who are pregnant or breastfeeding, or who have a birth plan in the next 3 months; (12) patients who are participating in any other drug or medical device clinical trial, or who may participate in any other drug or medical device clinical trial after enrollment in this clinical trial; (13) the investigator determines that there are other conditions that are not suitable for participation in this clinical trial.
fda: lowering orthopedic opioid dosing (flood)

Conditions: Post-operative Pain

Summary: this randomized trial evaluates an intervention to minimize use of opioids following total hip and total knee replacement. half the participants will receive an intervention (mailed educational materials, followed by a pharmacist call), and half will receive usual care.

surgeons and anesthesiologists prescribe opioids and other analgesic medications for acute, post-surgical pain. recent studies have reported that some patients persist in taking opioids for months beyond the surgery. while opioids are commonly used for pain management following surgery, patients and their providers often don't have a planned method to optimize opioid exposure. this can lead to patients entering a cycle of opioid use that is difficult to manage, because, as opioid exposure is continued, pain relief is reduced and side effects increase. the investigators' study is aimed at reducing opioid exposure following total hip and total knee replacement.

Eligibility criteria:
inclusion criteria: * total hip replacement or total knee replacement * 1 year membership with kpnw prior to enrollment exclusion criteria: * managed by pain clinic, in other pain management trial * patients at low risk of persistent opioid use
effectiveness of pharmacist interventions in difficult asthma

Conditions: Asthma

Summary: of the 5.2 million people with asthma in the uk, approximately one in every 40 have severe asthma that needs the maximum available treatments advised in national asthma guidelines (known as the 'british thoracic society / scottish intercollegiate guidelines network british guideline on the management of asthma'). despite this, asthma is still inadequately controlled in about half of these patients and they are classed as having 'difficult asthma'. there maybe potential for improvement of the care and health of these patients through better use of medicines and greater input from pharmacists, but more research is needed. the aim of the study is to measure the effects over six months of coordinated information and advice about medicines from hospital and community pharmacists on asthma control in patients with difficult asthma. the patients in the study (52 in total) will be recruited from adult patients attending a specialist difficult asthma clinic in a hospital. patients will be randomly chosen to have either an appointment with the specialist pharmacist (intervention group), or usual medical care (control group). usual care will involve seeing the consultant or specialist registrar (doctor) in the clinic. patients in the intervention group will receive i) assessment and education on asthma, and review of their inhaler technique, from a hospital advanced clinical pharmacist and ii) will also be referred for a medicines use review from their usual community pharmacist (chemist), to take place 1-2 months after their hospital clinic appointment. the advanced clinical pharmacist will be working closely with the consultant. results will be measured using methods that have been developed by experts in asthma and tested in previous research. asthma control will be measured using juniper's asthma control questionnaire. other measurements will cover quality of life, use of medication, use of healthcare resources, and inhaler technique.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of asthma * fulfil the criteria for difficult asthma (defined as persistent symptoms and/or frequent exacerbations despite treatment at step 4 or step 5 of the british tyhoracic society / sign asthma guidelines 2011) * adult patients age between 18 and 70 years * able to speak, read and write in english * all patients must have received their regular medication from the same community pharmacy for at least 3 months prior to their baseline visit * their community pharmacy must be registered with leeds primary care trust(pct) to undertake targeted medicines use reviews (tmurs). exclusion criteria: * failure to meet the inclusion criteria * patient is not responsible for administering their own medications * patient is unlikely to be available for the 6-month follow-up period * failure to provide written informed consent * patient has had an mur within the 12 months preceding the study period.

Keywords: pharmacy
addressing overdose risk among recently incarcerated people living with hiv/aids

Conditions: Drug Overdose Accidental

Summary: the overall objective of this study is to evaluate an educational overdose prevention intervention's effectiveness among incarcerated people living with hiv/aids, specifically within the context of other outcomes related to health and experiences after incarceration. results will be used to develop tailored interventions to reduce overdose deaths among high-risk correctional populations. the research has the following aims: * aim 1: evaluate a pilot program to provide hiv+ inmates with 1:1 overdose prevention training while incarcerated; * aim 2: identify the criminal justice, health, and hiv-related factors associated with overdose risk; and * aim 3: describe the overdose risk experiences of hiv+ former inmates who use opioids after release.

the goal of this research is to establish best practices to address overdose risk in people exiting incarceration, people living with hiv/aids (plwha), and both populations simultaneously. this contribution is important because this evidence has applications for correctional facilities and hiv clinical practice throughout the united states. the contributions of the proposed pilot study are: to provide evidence on the effectiveness of a targeted intervention on these two high-risk groups, generate exploratory data on predictors of overdose risk specific to hiv status and recent incarceration, and provide context about overdose risk and responses to witnessed overdoses in the first month after release. in this study, incarcerated plwha in the philadelphia department of prisons will be offered overdose training while incarcerated and naloxone (narcan) at release. study participants will be given a pre-test on overdose knowledge and attitudes and receive the overdose prevention intervention. those who are still incarcerated one month later will receive a post-test on overdose knowledge and attitudes. approximately one month after study participants are released from jail, they will be given a one-month follow-up survey that assesses: overdose knowledge and attitudes (post-test 2), information on personal or witnessed overdoses since release, health and post-incarceration related information, and characteristics of drug use since release. approximately 20 study participants will participate in a semi-structured interview 4-6 weeks after their release on their experiences with the overdose prevention intervention.

Eligibility criteria:
inclusion criteria: * hiv-positive * age 18 and over * speaks english * plans to live in philadelphia area after release exclusion criteria: * more than 10 months remaining on a sentence or release date unknown

Keywords: hiv/aids naloxone incarceration
preliminary evaluation of septin9 in patients with hereditary colon cancer syndromes

Conditions: Familial Adenomatous Polyposis; Map Syndrome; Lynch Syndrome; Hnpcc; Colorectal Cancer

Summary: this is an observational, case-control study evaluating the quantitative level of septin9 in plasma pre- and post-colectomy in hereditary colorectal cancer (crc) syndrome patients (familial adenomatous polyposis (fap), lynch syndrome (also known as hnpcc), and multiple adenomatous polyposis (map, also known as myk/myh) cases) and genetically related fap-family members as controls and references.


Eligibility criteria:
inclusion criteria: * informed consent provided * age \> or = to 18 years of age * patient group fap - clinical diagnosis of familial adenomatous polyposis * patient group lynch syndrome clinical diagnosis of lynch syndrome * patient group map - clinical diagnosis of myh-associated polyposis and presence of more than 20 colon polyps * control group (fap) - genetically related family member of patient * patients: able and willing to attend routine follow-up as advised * controls, i.e. relatives of patients: willingness to give blood at each routine follow-up as advised for the diseased relative exclusion criteria: * known infection with human immunodeficiency virus (hiv), hepatitis b virus (hbv), or hepatitis c virus (hcv) * current diagnosis of colorectal cancer * pregnancy

Keywords: familial adenomatous polyposis multiple adenomatous polyposis lynch syndrome hnpcc colorectal cancer genetic syndrome epigenomics septin9
long-term study of kad-1229 in type 2 diabetes patients

Conditions: Type 2 Diabetes

Summary: the purpose of this study is to evaluate the long-term safety and efficacy of kad-1229 as combination therapy with biguanide or dpp-4 inhibitor in type 2 diabetes patients who show inadequate glycemic control with diet, and biguanide or dpp-4 inhibitor monotherapy.


Eligibility criteria:
inclusion criteria: * type 2 diabetes patients who show inadequate glycemic control with diet, and biguanide or dpp-4 inhibitor monotherapy * age in the 20 years or over inclusive * hba1c in the range of ≥ 6.5 to \< 9% exclusion criteria: * type 1 diabetes mellitus * patients with serious diabetic complications and other serious complications

Keywords: type 2 diabetes hba1c long-term study
post-operative outcomes in the pyloromyotomy procedure under spinal anesthesia

Conditions: Postoperative Pain

Summary: infantile hypertrophic pyloric stenosis (hps) is one of the most common gastrointestinal medical emergencies.this retrospective study will review the files of all infants with hps, who were treated by open pyloromyotomy under spinal anesthesia in the bnai zion medical center between the years 2006 to 2015.

infantile hypertrophic pyloric stenosis (hps) is one of the most common gastrointestinal medical emergencies that occur during the first 2 months of life. anesthetic induction and airway management of infants with hps can be challenging because of the accumulation of significant volumes of gastric content, predisposing these patients to pulmonary aspiration during the induction of general anesthesia despite the correction of systemic metabolic alkalosis, cerebrospinal fluid can remain alkalotic, and in this context hyperventilation and opioids may increase the risks of post-operative central apnea. all of the above anesthetics risks urged some anesthetists to alternatively use spinal anesthesia (sa) in infants undergoing pyloromyotomy. this anesthetic technique proved to be both safe and efficient in infants undergoing pyloromyotomy, in addition to decreasing the mentioned risks associated with the other techniques. this retrospective study will review the files of all infants with hps, who were treated by open pyloromyotomy under sa in the bnai zion medical center between the years 2006 to 2015. it is designed to evaluate the postoperative full enteral feeding time, pain management and the incidence of post-operative apnea, the incidence of substantial vomiting episodes and other spinal anesthesia complications as secondary outcomes in infants undergoing pyloromyotomy under spinal anesthesia.

Eligibility criteria:
inclusion criteria: infants with hypertrophic pylorostenosis, treated by open pyloromyotomy under spinal anesthesia exclusion criteria: infants with hypertrophic pylorostenosis,treated by open pyloromyotomy under general anesthesia

Keywords: pyloric stenosis spinal anesthesia postoperative pain
establishment of squamous cell organoids of the head and neck to assess their response to innovative therapies

Conditions: Head and Neck Cancer

Summary: the emergence of tumor organoid cultures in recent years has made it possible to widen the repertoire of available preclinical tumor models and to bridge the gap between cell lines and tumors of xenografted patients in mice (pdxs).these organoids have the advantages of being able to be amplified fairly quickly after resection of the tumor, of having unlimited proliferation potential, a high rate of establishment success, and the possibility of being transfected and cryopreserved. these characteristics therefore allow them to summarize the clinical spectra of cancers, but also to be models for studying tumor progression as has been done with organoids for colorectal cancer. they are also very close morphologically and genetically to the tumor from which they derive.finally, clinical trials are underway to determine whether the organoids of mammary, pulmonary and colorectal cancers can predict the response to patients' treatments and guide the therapeutic decision.it would therefore be possible to test multiple treatments on different samples. this would allow screening of a panel of treatments on a given tumor type but also to test a treatment ex vivo before administering it to the patient in vivo. this prospect is very interesting in particular in the tumors of the vads where more than two thirds of the operated patients will benefit from a complementary treatment by radiotherapy and / or chemotherapy whose consequences can be important. despite this adjuvant management, up to 30% of patients will relapse, highlighting a variable tumor chemosensitivity. this screening could make it possible to refine the choice of treatments adapted to each patient and thus limit the undesirable effects.the feasibility of establishing head and neck squamous cell organoid lines seems encouraging, with organoids derived from squamous cell carcinoma of the oral cavity and oropharynx having been recently established.


Eligibility criteria:
inclusion criteria: * patient over 18 years of age; * patient with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx or larynx, classified t3nx or t4nx or t2n +, not previously treated; * patient to be treated by surgery; * patient affiliated to a social security scheme; * no opposition to participate in the study exclusion criteria: * pregnant woman ; * persons deprived of their liberty or under guardianship (including curatorship); * history of malignant pathology preceding inclusion (apart from basal cell carcinomas of the skin and carcinomas in situ of the cervix treated surgically) or concomitant at inclusion (synchronous tumor)

Keywords: organoid
taiwan registry for leadless pacemaker

Conditions: Sick Sinus Syndrome; Atrioventricular Block

Summary: taiwan registry for leadless pacemaker is a nationwide registry for leadless pacemaker performance in taiwan.

the purpose of this registry is to investigate the safety and efficiency performance of the leadless pacemakers in taiwan. the registry will collect all the information about the patient selection, implantation procedure, and follow up parameters of the leadless pacemakers to evaluate the real-world benefit specifically in taiwan population.

Eligibility criteria:
inclusion criteria: 1. the patients who had successfully received leadless pacemaker implantation 2. the patients who attempt to receive leadless pacemaker implantation exclusion criteria: n/a

Keywords: leadless pacemaker taiwan