Kornimate/medical-research-clean huggingface dataset:
application of index of microcirculatory resistance to evaluate myocardial protection after ischemic adaptation

Conditions: Acute Myocardial Infarction

Summary: to evaluate the protective effect of ipc on the myocardial microcirculation response through imr and the predictive value of imr on the degree of myocardial reperfusion and the prognosis of patients.

this study is a clinical randomized controlled study, applying index of microcirculatory resistance (imr) to evaluate the myocardial protection of ischemic postconditioning (ipc) in patients receiving direct pci treatment for acute myocardial infarction.imr is a quantitative evaluation index of microcirculation status. ipc has been reported to reduce ischemia-reperfusion injury and has a myocardial protective effect.the research plan divides patients into ipc and non-ipc groups at random. after the infarction-related artery is successfully implanted with a stent, the pressure guide wire is used to measure imr and cfr in the state of maximal expansion of the microcirculation induced by intravenous atp infusion.and analyze whether there are differences in indicators between the two groups and the relationship between these indicators and the patient's myocardial level reperfusion, cardiac function and prognosis.the purpose is to evaluate the myocardial protection of ipc and the predictive value of imr on the degree of myocardial reperfusion and the prognosis of patients. it is expected that the target ipc can improve the imr value, and imr can predict the degree of myocardial reperfusion and cardiac function and prognosis.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years old, no gender limit; * first episode of stemi (diagnostic criteria: ischemic chest pain lasting ≥30min; st-segment elevation in two or more adjacent leads on the ecg or new left bundle branch block; with or without elevated myocardial markers), the onset time is within 12 hours, and emergency interventional treatment is planned; * agree and cooperate to participate in this research. exclusion criteria: * old myocardial infarction; * killip grade of cardiac function ≥ grade iii or cardiogenic shock; * systolic blood pressure ≤100mmhg; * bradycardia, hr\<60pbm, or avb above ii degree; * past history of asthma or severe copd; * severe liver and kidney dysfunction.
intubation conditions with atracurium after three minutes

Conditions: Obesity Female Patients Require General Anaesthesia With Intubation and Atracurium Curarization

Summary: the purpose of this study is to evaluate intubation conditions with the use of atracurium after a fixed three-minute delay

the recommended dose of a non-depolarizing curare to facilitate tracheal intubation is twice the active dose 95 (the dose that reduces muscle force by 95%). at this dosage, curarization of the laryngeal adductors allowing relaxation and abduction (opening) of the vocal cords is considered certain. with atracurium, the dose for intubation is 0.5 mg.kg-1 and the time to full effect is approximately 3 minutes. with the use of newer hypnotics, there are no data evaluating the conditions for intubation after a fixed time of 3 minutes as with current anesthetic practices.

Eligibility criteria:
inclusion criteria: * adult female * patient to undergo general anesthesia with intubation for scheduled gynecological surgery * patient informed about the study and not opposed to it exclusion criteria: * patients with severe and morbid obesity (bmi\>35kg/m2) * pregnancy * patients with difficult intubation * allergy to atracurium and to any other drug used. * patient under tutorship / curatorship * not affiliated with social insurance * patient with ame

Keywords: tracheal intubation atracurium
ocular and palpebral manifestations of mastocytosis (mooma)

Conditions: Mast Cell Activation Disease; Mast Cell Activation Syndrome; Mast Cell Disease; Urticaria Pigmentosa

Summary: mastocytosis is a rare condition characterized by an accumulation of mast cell cells in one or more organs such as the liver, bone marrow, spleen and intestines. its prevalence in the general population is 1 in 10,000. this pathology is due to the proliferation of a mast cell clone and the excessive release of inflammatory mediators which lead to abnormal tissue infiltration. to date, there are only a few cases reporting ocular and orbital manifestations of mastocytosis. our prospective, interventional and single-center study consist in describing the ocular functional manifestations and ocular surface abnormalities of patients with systemic and cutaneous mastocytosis.

patient with systemic or cutaneous mastocytosis will be included in the study. data about organ involvement of mastocytosis will be collected. participants will be screened with a medical and eye disease history. they will also have an eye exam. participants will provide a tears sample.

Eligibility criteria:
inclusion criteria: * have a diagnosis of mastocytosis * male or female, 18 years of age and over * ability to understand and provide written informed consent. exclusion criteria: * disorders that do not allow good visualization of the posterior pole (cataract, intravitreal hemorrhage) * patients with another ocular pathology that may bias the results (corneal dystrophy, dysthyroid orbitopathy, retinal pathologies) * history of refractive surgery
lymphatic mapping and sentinel lymph node biopsy in the treatment of colorectal cancer

Conditions: Colorectal Cancer

Summary: rationale: diagnostic procedures, such as lymph node mapping and biopsy, may improve the ability to detect the extent of colorectal cancer. purpose: diagnostic trial to study the feasibility of lymph node mapping and sentinel lymph node biopsy in patients who have stage i, stage ii, or stage iii colorectal cancer.

objectives: i. determine the feasibility of lymphatic mapping and sentinel lymph node biopsy in patients with stage i, ii, or iii colorectal cancer. ii. evaluate technetium tc 99m sulfur colloid as a mapping agent in this patient population. iii. identify patients with histologically negative nodes but have positive nodes on further detailed examination. outline: patients undergo preoperative endoscopy with injection of technetium tc 99m sulfur colloid around tumor followed by celiotomy and intraabdominal exploration. at 30 minutes following injection, patients undergo lymphatic mapping with a gamma probe and biopsy of the sentinel lymph node(s). following biopsy and mapping, patients undergo resection of primary tumor. patients are followed postoperatively, every 4-6 months for 2 years, every 6 months for 1 year, and then annually thereafter. projected accrual: a total of 10 patients will be accrued for this study within 2 years.

Eligibility criteria:
disease characteristics: preoperative diagnosis of stage i, ii, or iii colorectal cancer no more than 90 days since diagnosis no tumor involving adjacent structures (t4 lesion) no clinical or radiological evidence of stage iv disease no total excision of primary tumor at diagnosis patient characteristics: age: 18 and over performance status: karnofsky 60-100% life expectancy: not specified hematopoietic: not specified hepatic: no severe decompensated liver disease, including cirrhosis renal: not specified other: no known primary or secondary immunodeficiencies no other medical conditions or evidence of infection that would preclude study not pregnant negative pregnancy test prior concurrent therapy: see disease characteristics no prior colonic, aortic, or retroperitoneal surgery

Keywords: stage i colon cancer stage ii colon cancer stage iii colon cancer stage i rectal cancer stage ii rectal cancer stage iii rectal cancer
tiotropium/salmeterol inhalation powder (spiriva handihaler and salmeterol polyethylene (pe) capsule) in chronic obstructive pulmonary disease (copd)

Conditions: Pulmonary Disease, Chronic Obstructive

Summary: the primary objectives of this study are to assess bronchodilator efficacy as determined by forced expiratory volume in one second (fev1), the effect on dyspnoea as determined by the baseline dyspnoea index/transition dyspnoea index (bdi/tdi), the effect on health status as determined by the st george respiratory questionnaire (sgrq) and the effect on chronic obstructive pulmonary disease (copd) exacerbations.


Eligibility criteria:
main inclusion criteria: * diagnosis of copd * post-bronchodilator fev1\<80% predicted and fev1/fvc\<70% predicted main exclusion criteria: * significant other diseases then copd * recent myocardial infarction (mi) * unstable or life-threatening arrythmia requiring intervention or change in drug therapy * hospitalisation for cardiac failure in past year * history of asthma
non-invasive nerve stimulation for ptsd and sleep

Conditions: Post Traumatic Stress Disorder; Traumatic Brain Injury

Summary: in this study, our objective is to determine the effect of two different nerve stimulation types in changing sleep architecture.

persons suffering from ptsd or mild tbi may suffer from sleep deprivation. the purpose of this study is to explore options to improve sleep quality.

Eligibility criteria:
inclusion criteria: * veterans with history of ptsd with and without history of mild tbi exclusion criteria with: * history of severe psychiatric illness unrelated to ptsd or tbi * other medical conditions of severity that may impair cognition * current illicit or prescription drug abuse * breathing disorder requiring constant use of oxygen

Keywords: nerve stimulation sleep deprivation
the flashing light-induced pupil response (flipr) glaucoma study

Conditions: Glaucoma, Open-Angle; Eye Diseases

Summary: this study is designed to investigate whether the pupil response to slowly flashing colored lights is significantly altered in patients with glaucoma, as compared to a control group of subjects without glaucoma.

the pupils inside the eyes constrict in response to light stimulation. different classes of cells within the human retina initiate this response. recent research suggests that one of the ganglion cell types involved in this pupil response is affected by glaucoma. by measuring pupil responses to different colored lights, the function of this class of cells can be evaluated quickly, and without touching the eye. an advantage of pupil testing strategies is that they do not require subjective feedback from the subject about what they can see, as is required for standard visual field tests that are used in the clinic. the main aim of this study is to measure and compare the pupil constriction that occurs in response to flickering red and blue lights in patients with glaucoma versus matched control patients without glaucoma. in addition, the subjects will be asked questions about their quality of life and it will be determined whether issues related to quality of life correlate to alterations in the pupil responses.

Eligibility criteria:
inclusion criteria: * 18+ years old * diagnosed with glaucoma of known severity (cases only) * have a refractive error between +4.00 and -8.00 sphere power, and no more than 3.00 diopters of astigmatism * best corrected visual acuity of 20/40 or better in each eye * have open anterior chamber angles exclusion criteria: * diagnosis of glaucoma of a type other than primary open angle (cases only) * history of having surgery or taking medications known to profoundly affect pupillary function or shape * visual field defect (controls only) * history of traumatic brain injury requiring hospitalization * pregnancy * history of optic nerve disease other than glaucoma * history of retinopathy * history of unreactive pupils * presence of significant cataract

Keywords: glaucoma pupil melanopsin
multimodal analgesia in cardiac surgery (pilot study)

Conditions: Heart Diseases

Summary: the investigators objective is to assess the effectiveness of an opioid sparing multimodal approach for enhancing the recovery in cardiac surgical patients. this model would use a combination of intravenous (dexmedetomidine, ketamine, lidocaine) and spinal (morphine) drugs.

cardiac surgery is associated with significant acute pain and a proportion of these patients will develop chronic pain. opioids are the main stay of analgesia in cardiac surgery because of the safer hemodynamic profile and sedation. however high dose narcotic use is associated with a variety of unwanted side effects prolonging postoperative recovery. there is growing evidence for the effectiveness of multimodal approach utilizing opiate sparing techniques for enhancing patient recovery following surgery. early extubation has been associated with improved patient outcome and cost effectiveness in cardiac surgery. the investigators objective is to assess the effectiveness of an opioid sparing multimodal approach for enhancing the recovery in cardiac surgical patients. this model would use a combination of intravenous (dexmedetomidine, ketamine, lidocaine) and spinal (morphine) drugs. all of the above anesthetic drugs have opioid sparing effect in surgical patients. dexmedetomidine use has been associated with decreased cardiac arrhythmias and improved neurological outcome in cardiac surgical patients. ketamine has been linked with attenuation of postoperative cognitive dysfunction after cardiac surgery. both intravenous lidocaine and spinal morphine have been shown to reduce opioid consumption in the perioperative period.

Eligibility criteria:
inclusion criteria: * elective cabgs and/or valve replacements, ≥ 18 years old exclusion criteria: * re-do cardiac surgery, acute endocarditis, circulatory arrest, emergent cases, shock, left ventricular assist device, transplantation, transcatheter aortic valve replacement, contraindications for spinal including coagulopathy and clopidogrel \ 2 times normal) and renal dysfunction (cr \> 2 mg/dl), inability to administer spinal anesthetic, preoperative opioid use, patients who are unable to give their own consent, expected prolonged intubation postoperatively (\>12 hrs), prisoners, pregnancy
acu-tens on pain and stress reduction before and during tugor

Conditions: Oocyte Retrieival and Post Operative Pain Control; Acupuncture

Summary: objectives: to demonstrate the use of acupuncture-type transcutaneous electrical nerve stimulation (acu-tens) during transvaginal ultrasound-guided oocyte retrieval (tugor) will reduce 50% of the intensity of pain experienced by women. hypothesis to be tested: does the use of acu-tens reduce 50% of pain in tugor? design and subjects: a prospective randomized control trial will be carried out at the department of obstetrics and gynaecology, prince of wales hospital. 144 women undergoing tugor will be randomized to receive acu-tens or sham acu-tens for pain control during tugor. study instruments: during the tugor procedure, ultrasound of the pelvis will be performed by aloka prosound ssd-3500sx device (japan). each follicle will be pierced using a single lumen ovum aspiration needle or a double lumen ovum aspiration catheter (cook medical, uk) under ultrasound guidance. acu-tens will be done using mtr+ myolito multifunctional stimulator. main outcome measures: primary outcome is the pain score before and during tugor. secondary outcomes include (1) other pain level parameters including pain control satisfaction, surgeon's assessment of the patient co-operation score and patient intraoperative pain; (2) stress and anxiety levels, stait trait anxiety inventory, general health questionnaire, beck depression inventory, and saliva cortisol; (3) patient's satisfaction measured by client satisfaction questionnaire and satisfaction score on pain control; (4) difficulty in retrieving oocytes; (5) ivf parameters; (6) safety profile; and (7) bias assessment. data analysis: data analysis will be performed using statistical packages of social sciences for windows. expected results: the investigators expect that acu-tens will reduce 50% of pain in tugor.


Eligibility criteria:
inclusion criteria: * women undergoing ivf-et cycles are to be recruited from the assisted reproduction technology unit in the prince of wales hospital exclusion criteria: * patient not eligible for acu-tens * patient with severe cardiac and respiratory disease history * smoker or drinker * refuse or incompetence for informed consent

Keywords: transvaginal ultrasound-guided oocyte retrieval acupuncture-type transcutaneous electrical nerve stimulation pain control
picsi rct in couples with a previous poor fertilisation cycle in ivf

Conditions: Infertility; IVF

Summary: poor fertilisation plays a significant role in poor artificial reproductive technique outcomes. male factor infertility accounts for a large portion of such cases. several modalities have been proposed as a solution, including physiological intra-cytoplasmic sperm injection (picsi). picsi is a technique used to select the sperm to use in intra-cytoplasmic sperm injection (icsi) treatment. it involves placing sperm with hyaluronic acid, a natural compound found in the body. picsi identifies sperm that can bind to hyaluronic acid and these sperms are selected for use in treatment. some studies have suggested that pisci may be advantageous to reduce miscarriage. however, the evidence is not strong and it remains unknown if picsi is effective in a selected group of couples with a history of poor fertilisation. based on previous medical records, we observed a higher clinical pregnancy rate (cpr) and a trend towards lower miscarriage rates with picsi. to verify the findings and address the clinical gap, we propose a randomised controlled trial (rct) with 234 couples (117 in each group) to evaluate the effectiveness of picsi comparing with icsi for improving cpr and reducing miscarriage rate in couples with a fertilisation rate of \<50% in their first cycle of icsi.


Eligibility criteria:
inclusion criteria: * couples with \<50% fertilisation in their first icsi cycle, and scheduled for their second icsi/picsi cycle exclusion criteria: * women with diminished ovarian reserves (amh \<1.2ng/ml) or severe endometriosis (rafs stage iii or iv) * male partner with severe oligoasthenoteratozoospermia (density \< 5 million, total motility \< 40) or those require surgically retrieved sperm * couples using donor gametes * couples using frozen gametes * couples undergoing split ivf-icsi cycles * couples where a freeze all approach has been done, either clinically indicated or secondary to patient choice

Keywords: picsi
assessment of a teachable moment for smoking cessation

Conditions: Nicotine Dependence

Summary: a teachable moment (tm) refers to life events or transitions, such as physician visits, early detection screening feedback, pregnancy, and hospitalization for, and diagnosis of, disease, that inspire health behavior change. despite strong intuitive appeal of the tm concept and over 150 studies of interventions implemented in a tm, there has been little investigation of the influence of tms for smoking, particularly for promoting smoking cessation among those indirectly affected by a tm (e.g., relatives of cancer patients). this prospective observational study using a matched-group design will assess whether a lung cancer diagnosis increases enrollment in a smoking cessation program and cessation, and reduces smoking, among the patient's relatives/spouse who smoke. we will compare enrollment in a cessation program and cessation and smoking rates in 2 groups of smokers: 1) relatives/spouses of newly-diagnosed lung cancer patients, and 2) relatives/spouses of patients with an orthopedic condition. we will also explore mediators and moderators of a lung cancer diagnosis as a tm. this study could clarify the tm concept for smoking cessation, shed light on the underlying mechanisms of tms, and guide future development and implementation of tm-based smoking cessation interventions.


Eligibility criteria:
inclusion criteria: 1. a relative (i.e., sibling, parent, child, grandparent, aunt, uncle, cousin) or spouse of a newly-diagnosed lung or head and neck cancer patient or orthopedic patient (e.g., arthritis, bone and joint infection, foot and ankle conditions, hand, wrist, and elbow conditions such as carpal tunnel syndrome, shoulder and elbow conditions, such as rotator cuff injury, and knee conditions, such as ligament damage repair); 2. a regular smoker (i.e., smoke 10 cigarettes/day on average); 3. able to use nrt (see contraindications under key exclusion criteria); 4. age 18 or older (to use nrt); and 5. living within \~50 miles of penn (to allow for meetings at penn). exclusion criteria: 1. cannot communicate in english; 2. have current alcohol abuse/dependence; 3. are or have been diagnosed with cancer, asthma, hiv, emphysema, or copd; 4. have a current medical problem for which nrt is contraindicated such as uncontrolled hypertension (\> 150 over 90), unstable angina, heart attack or stroke within the past 6 months, and liver and/or kidney failure in the last 6-months; 5. currently use monoamine oxidase inhibitors or benzodiazepines, anti-psychotics, and antidepressants, including bupropion; 6. are allergic to adhesive tape or latex, and 7. are a female who is pregnant or nursing.

Keywords: smoking teachable moment cancer
opioid-free anesthesia in thyroidectomies

Conditions: Pain, Post Operative; Pain, Acute; Pain, Chronic; Pain, Neuropathic; Pain, Nociceptive; Ketamine; Dexmedetomidine; Lidocaine; Fentanyl; Analgesia; Analgesics; Analgesics Non-narcotic

Summary: the aim of this study will be to investigate the effect of an opioid-free anesthesia regimen with a mixture of dexmedetomidine-lidocaine-ketamine in the same syringe versus fentanyl analgesia in elective thyroidectomies. recovery parameters and nociception levels throughout the operation will be evaluated

in the usual anesthetic practice opioids are often administered in the perioperative period for intraoperative analgesia to control the nociceptive pathway of pain and post-surgical pain management. however, in recent years, opioid free anesthesia (ofa) has become increasingly popular, in which opioid administration is avoided intraoperatively and minimized or avoided in the postoperative period. opioid-free anesthesia (ofa) has been shown to decrease postoperative complications associated with opioids, include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. therefore, the investigators aim to perform this study to determine a goal-directed approach, which targets adequate antinociception (e.g., by measuring nociceptive/antinociceptive balance) that could reduce the negative effects of excessive drug infusion, prevent postoperative pain and improve patient outcomes.

Eligibility criteria:
inclusion criteria: * adult patients * american society of anesthesiologists (asa) classification i-ii * elective thyroidectomy exclusion criteria: * body mass index (bmi) \>35 kg/m2 * contraindications to local anesthetic administration * systematic use of analgesic agents preoperatively * chronic pain syndromes preoperatively * neurological or psychiatric disease on treatment * pregnancy * severe hepatic or renal disease * history of cardiovascular diseases/ arrhythmias/ conduction abnormalities * bradycardia(\<55 beats/minute) * drug or alcohol abuse * language or communication barriers lack of informed consent
dermacyd femina (lactic acid) pocket br - photo evaluation

Conditions: Hygiene

Summary: to demonstrate the absence of photoirritation and photosensitization potential of the product dermacyd femina (lactic acid) pocket br.


Eligibility criteria:
inclusion criteria: * age between 18 and 60 years old; * phototype skin i,ii, iii e iv * integral skin test in the region; * willingness in following the study procedures and to be present in the clinic at the days and scheduled time for medical evaluations and for application of occlusion; exclusion criteria: * lactation or gestation * use of antiinflammatory and/or immunosuppression drugs one month before the study; * personnel history of atopy; * history of sensitivity or irritation for topic products; * active cutaneous disease; * use of new drugs or cosmetics during the study; the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.