Kornimate/medical-research-clean huggingface dataset:
prevalence, risk factors and consequences related to cesarean scar defect (defect in cesarean scar)

Conditions: Cesarean Scar Defect

Summary: the rates of cesarean section (cs) are rising all over the world. worldwide the number of cs is millions every year. cs is one of the most frequently performed operation for women. as a consequence many women have a scar in their uterus. cesarean scar may be associated with complications in later pregnancies. in recent years there have also been a few reports indicating that cesarean scar could potentially be associated with menstrual disorders and infertility. the impact of cesarean scar defect on long term welfare or quality of life is not clear. in some women with a history of cs it is possible to recognise a defect in the site of previous uterotomy years after the performed cs by sonographic examination. this defect in the scar, also called as a niche, is a consequence of incomplete healing of the scar in the lower part of uterus. to date there is uncertainty relating to the factors that lead to poor healing of cesarean scar. also impact of cesarean scar defect on later well-being and later pregnancies are not properly known. the purpose of this study is to investigate the prevalence and the risk factors of cesarean scar defect. also the impact of cesarean scar defect on women´s menstrual health, fertility, further deliveries and quality of life will be investigated. this study is a prospective observational cohort study. women at the age of 18-45 years who will give birth by elective or emergency cs will be asked to participate. women are recruited within two days of cs. women with known uterus anomaly or von willebrand disease will be excluded. the prevalence of scar defect will be evaluated by transvaginal sonography and contrast-enhanced sonohysterography using saline infusion. both 2-dimensional and 3-dimensional sonography will be used. sonographic evaluation will take place 6 months after the cs. the following definition for cs scar defect will be used: myometrial discontinuity with a depth of ≥2 mm at the site of cesarean scar that communicates with the uterine or cervical cavity as seen on transvaginal sonography with or without saline infusion. the prevalence of menstrual disorders will be evaluated 12 months after the cs. the subjects will be asked to report the number of menstrual bleeding days once a month during 3 consecutive months. postmenstrual spotting is defined as ≥2 days of brownish discharge at the end of menstruation with total bleeding days of ≥7 or non-cyclic bleeding not related to menstruation.


Eligibility criteria:
inclusion criteria: * women who gives birth by cesarean section whether it will be an elective surgery or an emergency surgery during labour exclusion criteria: * uterus anomaly or von willebrand disease * informed consent not provided
test for pre operative skin preparations

Conditions: Topical Antisepsis

Summary: compare 2 application techniques of chloraprep swabstick--3 swabsticks at once versus 3 swabsticks used sequentially. hibiclens applied according to the manufacturer's directions. sterile swabsticks (wetted with sterile deionizd water) applied using the same method as the chloraprep swabstick.

determine differences (if any) in 2 different application techniques of chloraprep swabstick--3 swabsticks at once versus 3 swabsticks used sequentially. hibiclens, a liquid antibacterial soap, applied according to the manufacturer's directions as a active/positive comparison. sterile swabsticks (wetted with sterile deionized water) applied as a negative comparison using the same method as the chloraprep swabstick. study uses topical sampling from the abdomen and the groin on intact skin and evaluates the germs left on the skin after treatment with chloraprep swabsticks.

Eligibility criteria:
inclusion criteria: * subjects must read and sign an informed consent form and be cooperative. * subjects must be in good general health. * subjects must have skin within 6 inches of the test site that is free of tattoos, dermatoses, abrasions, cuts, lesions, or other skin disorders. exclusion criteria: * use of systemic or topical antimicrobials during the 2-week pretest conditioning period. this restriction includes but is not limited to shampoos, lotions, soaps, baby powders, and materials, such as solvents, acids, or alkalis. * a medical diagnosis of a physical condition, which would preclude participation such as: diabetes, hepatitis, an organ transplant, a medical surgical implant, or an immunocompromised system. * any medical condition that in the opinion of the investigator would preclude participation. * bathed in chemically treated pools or hot tubs 2 weeks prior to any microbial sampling. * used uv tanning lamps 2 weeks prior to any microbial sampling. * bathing or showering less than 48 hours prior to any microbial sampling. * known sensitivity to chlorhexidine gluconate. * known sensitivity to latex (rubber). * known sensitivity to fragrances. * pregnant or nursing. * unwillingness to fulfill the performance requirements of the study. * subjects who have completed part or all of the study will not be reentered in the study.

Keywords: antimicrobial antisepsis
monitoring the effect of red blood cell transfusion on cerebral oxygen saturation with near infrared spectroscopy (nirs) in critically ill patients

Conditions: Effect of RBC Transfusions on Cerebral Oxygen Saturation

Summary: critically ill patients are frequently transfused with red blood cell (rbc) units with the predominant intention to increase arterial oxygen content and thus oxygen delivery to the tissues. to date, rbc transfusions have been proven effective in patients with profound anaemia or circulatory shock. however, the impact of the storage process and the so-called storage lesion on oxygen-carrying properties and, hence, the efficacy of rbc transfusion regarding tissue oxygenation are much debated at present. alterations of rbc physiology have been comprehensively described ex vivo. reduced deformability, increased adhesiveness and aggregability of stored rbc impair their rheological properties; anaerobic cellular metabolism with reduced contents of 2,3 bisphosphoglycerate and adenosine triphosphate (atp) increases oxygen affinity and impairs oxygen release to the tissues. this study aims to monitor the effect rbc transfusion has on the regional cerebral oxygen saturation (rso2) of critically ill patients. rso2 will be measured indirectly, using near infrared spectroscopy (nirs) . patients will be monitored once it looms that they might require rbc transfusion. the monitoring is continued for the time of transfusion and the hours afterwards.


Eligibility criteria:
inclusion criteria: * expected requirement of rbc transfusion * 18 yrs and older exclusion criteria: * severe traumatic brain injury (glasgow coma scale \< 9), subarachnoid hemorrhage (hunt and hess scale ≥ 3) or intracranial hemorrhage * cerebral ischaemia * active bleeding * patients necessitating ongoing resuscitation * deficient signal of rso2 impeding its proper valuation

Keywords: anemia nirs near infrared spectroscopy rbc transfusion critical ill regional cerebral oxygen saturation tissue oxygenation
lipoprotein apheresis in refractory angina study

Conditions: Refractory Angina; Raised Lipoprotein(a)>50mg/dL or >500mg/L

Summary: the goal of this study is to determine the impact of apheresis on clinical parameters and symptoms of patients with refractory angina and raised lp(a). the investigators will conduct a prospective, randomised controlled crossover study of 20 patients with refractory angina and raised lp(a), randomised to undergoing lipoprotein apheresis weekly for three months or sham apheresis weekly for three months with assessment of myocardial perfusion, carotid atherosclerosis, endothelial vascular function, thrombogenesis, exercise capacity, angina symptoms and quality of life at the beginning and end of treatment. patients will then crossover to the opposite study arm with the protocol repeated. the hypothesis is that the above parameters will be improved by lipoprotein apheresis in patients with raised lp(a) and refractory angina. investigators will also test for the genotypic presence of apolipoprotein(a) gene (lpa) locus variants (rs10455872 and rs3798220) which are thought to be associated with an increased level of lp(a) and an increased risk of coronary disease.

angina which is refractory to conventional medical therapy and revascularisation is challenging to manage. lipoprotein(a) or lp(a) is a genetically determined form of ldl-cholesterol, elevation of which is an independent risk factor and predictor of adverse cardiovascular events. lp(a) is felt to increase cardiovascular risk via its prothrombotic effect and by enhancing intimal lipoprotein deposition. lipoprotein apheresis is the most effective treatment for raised lp(a). lipid lowering agents such as statins have little to no effect on lp(a) levels.

Eligibility criteria:
inclusion criteria: * patients diagnosed with refractory angina for more than three months. * two or more episodes of angina per week. * previous history of myocardial infarction, coronary artery bypass graft (cabg) surgery,percutaneous coronary intervention (pci) or any combination of the above. * prescribed optimal medical therapy. * hypercholesterolaemia with an elevated lp(a) \> 50mg/dl and an ldl-cholesterol less than 4.0mmol/l despite optimal lipid lowering drug therapy. exclusion criteria: * patients with poor calibre veins for cannulation. * patients with any other chronic systemic illness such as liver or renal failure, neoplastic disease, overt cardiac failure, unstable coronary artery disease, coronary revascularisation or a myocardial infarction within the previous eight weeks. * pregnancy, untreated diabetes mellitus, untreated arterial hypertension, and those with general contraindications to undergoing cardiovascular magnetic resonance imaging or contraindications to adenosine.

Keywords: refractory angina lipoprotein
high definition neuromuscular stimulation in tetraplegia

Conditions: Spinal Cord Injury at C4-C6 Level

Summary: the purpose of this study is to demonstrate high definition non-invasive neuromuscular stimulation of an upper extremity in tetraplegic participants.

spinal cord injury (sci) is an insult to the spinal cord resulting in a change, either temporary or permanent, in its normal motor, sensory, and/or autonomic function. it is estimated that the annual incidence of spinal cord injury (sci), not including those who die at the scene of the accident, is approximately 40 cases per million population in the u. s. or approximately 12,000 new cases each year. the purpose of this study is to demonstrate high definition non-invasive neuromuscular stimulation of an upper extremity in tetraplegic participants. this study will plan to enroll up to 15 subjects who have been diagnosed with tetraplegia. the total duration of the study is expected to be about 18 months, and each participant is expected to be on the study for about 6 months. the study design will consist of the following two (2) phases listed below. i. baseline assessment and calibration (approximately 1 month) ii. testing motions: pre-sequenced and eeg-triggered motions; further calibration as needed (approximately 5 months) phase i - baseline * medical history review * physical and neurological exam * emg * fit and calibrate external stimulator: the battelle neuromuscular stimulator will be setup and calibrated to evoke wrist and hand/finger movements. phase ii - testing motions after the neuromuscular stimulator is setup and calibrated, various spatial and temporal stimulation patterns will be tested to evoke wrist/hand movements in various sequences of individual and combined movements.

Eligibility criteria:
inclusion criteria: * must be 21 years or older. * must be tetraplegic (c4-6 asia a) * 12 months post injury and neurologically stable * participant is willing to comply with all follow-up evaluations at the specified times. * participant is able to provide informed consent prior to enrollment in the study. * the participant is fluent in english. exclusion criteria: * no active wound healing or skin breakdown issues. * no history of poorly controlled autonomic dysreflexia. * other implantable devices such as heart/brain pacemakers * subjects who rely on ventilators

Keywords: reanimation stimulation
benefit of hypnosis on pain during stitches in emergency room

Conditions: Wound of Skin

Summary: suturing is a daily practice in the emergency department, but it can be painful and stressful for patients. hypnosis is increasingly used as a complement to the usual painkillers. the aim of our study was to investigate the impact of hypnosis on stitch placement in emergency department patients presenting with lacerations assessed by heart rate variability.

the aim of this randomized, controlled, single-center, prospective study is to evaluate the impact of hypnosis during suturing in emergency department patients presenting with a laceration assessed by heart rate variability. all patients with eligibility criteria will be included if the patient gave his written consent. patients will be randomized to one of two arms: (1) hypnosis or (2) standard of care (soc) a heart rate monitoring belt will be fitted to the patient for both groups. the patient will be asked to complete a self-assessment questionnaire on pain and stress, as well as socio-demographic parameters. a blood sample will be collected and the heart rate and blood pressure will be measured. stitches will be taken with or without hypnosis, and after 30 minutes, the pain and stress self-assessment questionnaire will again be completed by the patient, and a new blood test will be taken. the heart rate monitoring belt will be removed, and the study will be completed for the patient.

Eligibility criteria:
inclusion criteria: * patient over 18 years, admitted in clermont-ferrand university hospital emergency department * suturable wound * patient's consent obtained exclusion criteria: * pregnant or breast-feeding women * patient under guardianship, curators or safeguard of justice * person unable to give consent * history of cardiac rhythm disorders (fibrillation, pacemaker) * psychiatric pathology * age \< 18 years * surgical wound * eyelid, nose, ear or mouth wounds * patients who do not speak french * deaf patients * patients with no social security coverage * use of meopa * intake of toxic substances * head trauma with a glasgow score \< or = to 14 * patient with endocrinal pathologies on cortisol axe * refusal to take part in the study

Keywords: hypnosis wound stitches pain sinusal variability of cardiac frequency
brain and eye markers of facial expression recognition and disorders associated with autistic symptoms

Conditions: Brain Markers

Summary: in everyday life, it is necessary to adjust one's behavior and reactions in order to interact and communicate with others in an appropriate manner. this adaptation is done by taking into account the emotions of the people with whom we interact. this reading of emotions is done by using visible clues on the face, in particular by observing the eye area of the interlocutor. the aim of the study is to investigate how processes such as attention or memory influence emotion recognition, as well as (i) their alteration in the disease, and (ii) their link with the emergence of autistic and/or psychotic symptoms. we also want to study the implementation of compensatory strategies (used to compensate for difficulties in recognizing or perceiving emotions) and the link between the correct use of these strategies and the emergence of autistic and/or psychotic symptoms. the present project plans to include a total of 120 participants: 30 participants with asd, 30 patients with a particular genetic deletion 22q11.2 and 60 control participants. after the inclusion visit, participation in the study will be divided into two half-days in order to perform a neuropsychological assessment, an eeg study and an oculometry study.


Eligibility criteria:
inclusion criteria: * person, and if necessary his or her legal representative, who has given his or her non-objection * person whose mother tongue is french. * person aged between 7 and 50 years old. * person diagnosed with asd according to dsm-5 criteria, person with a genetic syndrome diagnosed by fish or cgh array (22q11 deletion), person with typical development matched in age and gender. * psychotropic treatment unchanged for one month and stable symptomatology. exclusion criteria: * recent addiction according to dsm-5 criteria, excluding tobacco. * pregnant women. * uncorrected visual acuity disorder. * use of somatic or psychic medication that may alter brain/psychic functioning (e.g. corticosteroids). * neurological disorder of vascular/infectious or neurodegenerative origin.
remote ischemic preconditioning in high risk cardiovascular surgery patients

Conditions: Death; Stroke; Low Cardiac Output Syndrome; Myocardial Infarction; Renal Failure; Pulmonary Failure

Summary: remote ischemic preconditioning (ripc) occurs when a tissue (ex. heart) becomes less vulnerable to an ischemic insult if a remote tissue (ex. arm) has had previous exposure to a period of ischemia and reperfusion. a beneficial effect of ripc has been demonstrated in several randomized studies in patients undergoing cardiac and vascular surgery, as well as interventional cardiac procedures such as angioplasty. they have shown improvements in cardiac, renal, neurologic and respiratory function. most have focused on surrogate outcomes, such as biochemical markers of cardiac and renal function in low-risk patients. no trials have investigated only high-risk patients or been designed to detect clinical outcomes. this study is a randomized-controlled trial powered to detect clinical events in a high-risk cohort undergoing cardiovascular surgery. patients will be randomized to ripc (exposed to cycles of inflation of a blood pressure cuff on the upper arm prior to undergoing surgery) or control (no ischemic stimulus). the investigators hypothesize this population will demonstrate lower rates of adverse ischemic events. the investigators also intend to sample biochemical markers to better elucidate the mechanism of ripc and generate hypotheses for future studies and interventions. post-operatively the investigators will monitor for adverse clinical outcomes including cardiac, renal, pulmonary and neurologic injury. ripc is simple, inexpensive and easily reproducible and there have been no reports of adverse consequences. post-operative ischemic events such as stroke, myocardial infarction, cardiac, renal and respiratory failure affect patient survival and quality of life, and represent a sizeable financial burden to health care. if beneficial effects of ripc are demonstrated, it will be widely applicable to the entire population of cardiac and vascular patients resulting in a widely-implemented change in practice.


Eligibility criteria:
inclusion criteria: * undergoing either cardiac or vascular surgical procedures and are deemed to be at increased risk of suffering adverse ischemia-related events (judged by pre-operative evidence of clinical ischemic conditions, pre-operative screening indicating cardiovascular disease or undergoing higher-risk surgery). exclusion criteria: * will not include emergency cases, patients with known vascular disease (ex. arterial occlusive disease, arterio-venous shunts) or neurologic disease affecting the upper limb and patients unable to give informed consent.

Keywords: ischemic preconditioning cardiac surgery vascular surgery
adolescent self-care and knowledge education in diabetes--improved by texting

Conditions: Type 1 Diabetes Mellitus

Summary: this study is a randomized controlled trial assessing diabetes knowledge (using a mercy-what i know about diabetes test (mwikad) validated survey) and self-care practices (using a validated self-management of type 1 diabetes-adolescence (smod-a) survey) at baseline, 3 months and 6 months. the intervention group will receive a minimum of 78 text messages related to diabetes over the course of 26 weeks from study enrollment. subjects are invited to respond to some text messages which will be in the form of a multiple-choice question and if they do, they will receive an additional text message in response to their answer.


Eligibility criteria:
inclusion criteria: 1. diagnosis of type 1 diabetes mellitus 2. receiving care in the pediatric clinic at the barbara davis center (bdc) 3. age 15-20 at study enrollment 4. english literate and english speaking 5. ability to complete the required surveys 6. have a personal cell phone with service compatible with eztexting platform 7. able to provide informed assent or consent (if 18 years of age or older) and parental informed consent (if needed). exclusion criteria: 1. not planning to continue care in the pediatric clinic at bdc for at least the next 6 months. 2. diabetes diagnosis other than type 1 diabetes 3. inability for the adolescent to respond to text messages (e.g. due to developmental delay)

Keywords: adolescent young adult knowledge self-care
effect of exercise on blood coagulation in persons with chronic spinal cord injury

Conditions: Cardiovascular Disease; Spinal Cord Injury

Summary: the purpose of this study is to determine if exercise affects the clotting of blood (hemostasis). the effect of exercise on hemostasis will be determined in persons with spinal cord injury, a population reported to have an increased prevalence of cardiovascular disease (cvd). it is expected that this study will increase our understanding of cvd in persons with sci, and it will eventually help reduce the occurrence of premature heart disease.

regular moderate intensity physical exercise decreases platelet aggregability as a consequence of increasing levels of tissue plasminogen activator (tpa) and reducing levels of plasminogen activator inhibitor-1 (pai-1). in addition, the exercise-associated improvement in the lipid profile and reduction in fat mass may decrease platelet aggregability and blood coagulation, as well as increase fibrinolysis. thus, it can be hypothesized that physical exercise training has a powerful beneficial impact on blood coagulation and fibrinolysis. although, regular exercise has been shown to reduce the incidence of cvd and death or causes a regression of symptoms in able-bodied individuals, this salutary effect of prolonged (months) exercise in persons with sci has not been documented. the present study will evaluate the effects on hemostasis of exercise training in persons with chronic sci. the effect of exercise on hemostasis will be determined in persons with sci, a population appreciated to have an increased prevalence of cardiovascular disease (cvd). it is anticipated that this study will ultimately increase our understanding of cvd in this group, and it will eventually help reduce the occurrence of premature macrovascular disease.

Eligibility criteria:
inclusion criteria: sci subjects (n=12) with stable chronic, complete paraplegia, (t1 to t10) and quadriplegia (c4 to c8) (for more than 1 year) will be recruited. the paraplegia subjects should be able to transfer independently in/out of a wheelchair. exclusion criteria: 1. ambulatory persons with sci 2. less than 18 years or greater than 65 years old 3. chronic illness (dialysis) 4. evidence or history of heart and/or vessel disease (arrhythmias, ischemia at rest) 5. platelet or coagulation disorders 6. prescribed use of on aspirin or non-steroidal anti inflammatory drugs 7. active illness (sepsis, pressure sores) 8. uncontrolled spasticity 9. contractures (fixed) in upper extremity/lower extremity heterotopic ossification at hips, knees, that limit range of motion while seated for fes

Keywords: cardiovascular disease exercise functional electrical stimulation hemostasis spinal cord injury