Kornimate/medical-research-clean huggingface dataset:
trigeminal endonasal perception: a predictor for septoplasty outcome

Conditions: Empty Nose Syndrome

Summary: this study investigates wether patients with increased trigeminal perception threshold and low expression of trp channels have more often nasal blockage despite functionally successful nasal surgery (trp channel = transient receptor potential channel).

the aim of this study is to find out wether patients with high trigeminal perception threshold (=decreased intranasal sensibility) and low expression of trp channels of the mucosa suffer more often from impaired nasal breathing after surgery. this could lead to the identification of prognostic factors and therefore prevention of nasal surgery with bad outcome. further, differences between patients with empty nose syndrome and asymptomatic patients after extended intranasal surgery, concerning trigeminal perception and trp channel expression will be investigated.

Eligibility criteria:
inclusion criteria: * patients undergoing a primary septoplasty and/or turbinoplasty * patients suffering from empty nose syndrome after measurably successful nasal surgery * patients with removed turbinates and/or septum, not suffering from ens (i.e. tumor patients) exclusion criteria: * patients with known neurologic disorders that could compromise perception threshold measurements * patients with known allergies/intolerance to test agents that are used to measure perception thresholds (cineol=eucalypt; menthol, co2= carbon dioxide) * inability to judge or understand the testing or the informed consent

Keywords: functional nasal surgery empty nose syndrome (ens)
implementing a healthcare provider education intervention in rural communities to reduce asthma morbidity

Conditions: Asthma

Summary: the aim of the study is to pilot test the implementation of healthcare provider education interventions to improve asthma outcomes in rural youth residing in bradford county, florida. the investigators propose to assess the feasibility and acceptability of implementing the easy breathing program a rural, medically underserved county and evaluate changes in healthcare provider practices and asthma-related outcomes of rural youth diagnosed with asthma.


Eligibility criteria:
inclusion criteria: * any child between 6 months and 18 years of age at one of the primary care clinics in braford county. exclusion criteria: * unable to meet inclusion criteria.
spaced education to optimize prostate cancer screening

Conditions: Prostate Cancer

Summary: two memory research findings (the spacing and testing effects) can dramatically improve retention of learning, but they have largely have been ignored by educators. the researchers have developed a novel form of online education (termed 'spaced education') based on these two effects which has been shown in randomized trials to improve knowledge acquisition and boost learning retention. using prostate cancer screening as an experimental system, the researchers investigated whether spaced education could durably improve clinicians' behaviors, not just their knowledge.


Eligibility criteria:
inclusion criteria: * primary care providers (physicians, nurse practitioners, and physician assistants) from the 8 veterans affairs (va) hospitals in the new england region (veterans integrated service network 1 \[visn-1\]) were eligible to enroll. exclusion criteria: * primary care providers (pcps) who ordered psa as a screen for prostate cancer less than 10 times each year were excluded.

Keywords: medical education educational technology clinical practice guideline prostate specific antigen
the role of substance p on perception of breathlessness during resistive load breathing

Conditions: Chronic Obstructive Pulmonary Disease

Summary: substance p is released from sensory nerves and transmits pain information into the central nervous system. as pain and dyspnea share many characteristics, including similar neurological pathways, it is possible that substance p may contribute to the sensation of dyspnea. the hypothesis of the study is that patients with chronic obstructive pulmonary disease (copd) will provide lower ratings of breathlessness during resistive load breathing with oral aprepitant, a medication that blocks the activity of substance p, compared with placebo.


Eligibility criteria:
inclusion criteria: * 50 years of age or older * diagnosis of copd * former smoker \> 10 pack-years * clinical diagnosis of chronic bronchitis * post-bronchodilator forced expiratory volume in one second (fev1) 30 - 80% predicted * fev1/forced vital capacity ratio less than or equal to 70% exclusion criteria: * current smoker * pregnant women * concomitant disease that might interfere with study procedures * peripheral vascular disease or cold hypersensitivity * drugs that might interfere with aprepitant

Keywords: dyspnea
inr comparison testing in cardiac surgery

Conditions: Coagulation Disorder

Summary: the investigator is testing blood samples to compare the results of two different techniques. since blood loss and the need for blood transfusions continue to be major problems after heart surgery and other types of surgery, the blood clotting levels are constantly checked during heart surgery as part of clinical care.the purpose of this study is to compare the inr levels in blood before and after the heart bypass during surgery.


Eligibility criteria:
inclusion criteria: * patients greater than or equal to 18 years of age. * patients undergoing elective surgery. * patients undergoing cardiac surgery. * patients to undergo general anesthesia with endotracheal intubation. * patients with well-controlled health disorders. exclusion criteria: * patients currently on coumadin or other anticoagulants; including, direct thrombin inhibitors and direct xa inhibitors. * patients who are under 18 years of age or pregnant. * patients undergoing emergency surgery. * patients with known coagulation disorders. * patients who are unable to provide informed consent in the form of a signature

Keywords: bleeding heart surgery coagulation coagulopathy inr
er:yag laser treatment of moderate chronic periodontitis

Conditions: Chronic Periodontitis, Generalized, Moderate

Summary: the er:yag laser possesses specific characteristics allowing to be used in non-surgical periodontal treatment. the aim of the resent study was to evaluate the long-term clinical effectiveness of er:yag laser monotherapy in the treatment of moderate chronic periodontitis and to compare it with conventional hand instrumentation. materials and methods: 451 teeth (1,099 periodontal pockets) from 30 patients with moderate chronic periodontitis (initial probing pocket depth 4 to 6 mm) were allocated for subgingival scaling and root planing in two groups - hand instrumentation (control) and er:yag laser instrumentation with 100mj/15hz (test). using a computerized periodontal probe, patients were examined for probing pocket depth (ppd), gingival recession (gr), clinical attachment level (cal), bleeding on probing (bop), plaque presence (fmps) at baseline, one, three, six and 12 months after instrumentation.


Eligibility criteria:
inclusion criteria: * at least two teeth per quadrant with ppd between 3,6 mm and 6,4 mm; * loss of clinical attachment up to 4 mm * bleeding on probing exclusion criteria: * periodontal treatment in the last 12 months; * systemic diseases; * systemic medication

Keywords: lasers periodontitis root planing treatment outcome
krill oil and muscle weakness in type 2 diabetes

Conditions: Diabetes Mellitus, Type 2

Summary: the age-related loss of muscle mass and function, sarcopenia, has several deleterious effects, such as a reduction in the quality of life and an increase in the incidence of falls, often leading to hospitalisation. the prevalence of sarcopenia is unclear but is estimated to be between 4.6 and 7.9% and the loss of skeletal muscle mass and function is accelerated in people with type 2 diabetes. with the percentage of older people and the percentage of people with type 2 diabetes predicted to rise in coming years it is crucial to develop therapies to increase muscle mass and function. alterations in nutrition have also been suggested to be of therapeutic use in sarcopenia. epidemiological data showed that the consumption of fatty fish is positively associated with muscle function in older population, indicating a potential role for long-chain n-3 polyunsaturated fatty acids (lcn-3 pufa) in increasing muscle mass and function in older people. the aim of the current study, therefore, is to determine the effects of krill oil supplementation on muscle size and function in adults with muscle weakness and type 2 diabetes.


Eligibility criteria:
inclusion criteria: * physician confirmed type 2 diabetes. * age \>/= 40 years * no changes in anti-diabetic medication in the last 3 months. * muscle weakness (grip strength \<27kg and females \<16kg) exclusion criteria: * bmi of 45 or higher * bp of 160/100mmhg or higher * cancer or cancer that has been in remission \<5 years * any medical condition that prevents participants from exercising safely * on anticoagulant therapy * allergies to seafood * regular consumption of more than 2 portions of oily fish per week * currently consuming omega-3 supplements
continuous positive airway pressure (cpap) compliance in obstructive sleep apnea

Conditions: Sleep Apnea, Obstructive; Patient Compliance

Summary: this study aims to determine the average compliance of a patient under cpap therapy for obstructive sleep apnea as well as the various factors that influence it.

obstructive sleep apnea (osa) is a frequent disease that affects 4% of the male population and 2% of the female population, with well known repercussions on the quality of life (daytime drowsiness, concentration issues, increased motor vehicle accidents, etc) and cardiovascular risk (increased risk of strokes, hypertension, diabetes, cad, etc.). it is caused by an intermittent relaxation of the throat muscles during sleep, thus blocking the airways and leading to snoring and apnea. treatment can involve diets and sports, sleep hygiene techniques, mandibular advancement devices. but the cpap (continuous positive airway pressure) device remains the first line therapy for osa. it is very effective at reducing apnea-hypopnea (ahi) and oxygen desaturation indexes (odi), but poor compliance is often noticed, with only 46% of patients still using the device at 6 months. despite numerous studies on the subject, very few have included a large number of patients(\>150) or long follow up time (\>1 year), or reached conclusive evidence concerning the factors that influence cpap compliance. in order to determine these factors, the investigators have taken into account approximately 450 patients over a timeframe of 5 years who have used a cpap device during the course of their disorder, and established a kaplan-meyer estimation of their survival function. the investigators have then used anthropometry (bmi, neck circumference, sex, age, etc.), polysomnography (epworth score, ahi, odi, sleep efficiency, etc.) and cpap (pressures, leaks, etc.) data with a cox regression in order to determine the factors that influence the compliance of a patient. the results will allow us to establish the average compliance of a patient under cpap therapy, as well as the reasons leading to its termination, the factors predicting a decreased compliance and the consequences of stopping the treatment. this will allow us to set up multiple methods of improved follow-up in patients that are predicted recalcitrant to cpap therapy.

Eligibility criteria:
inclusion criteria: * all hdf patients with osa, treated for at least one day by cpap, from the period of june 2008 to june 2013. exclusion criteria: * none

Keywords: continuous positive airway pressure
a home-based intervention to promote mindful breathing awareness through pursed-lip breathing training for copd patients

Conditions: Chronic Obstructive Pulmonary Disease

Summary: the mindful breathing laboratory under the direction of dr. benzo will complete a randomized controlled trial to evaluate the mindful breathing module. this rigorous study will evaluate home-based pr system compared to the home-based pr system plus mindful breathing module for its effects on breathlessness and emotions. the investigators hypothesize that the intervention will decrease breathlessness while increasing emotional perception, emotional intelligence, and mindfulness.

a total of 50 adults diagnosed with copd will be enrolled in this study. half of the subjects will be randomized to receive home-based pulmonary rehabilitation with the mindful breathing module (intervention group) and half will receive home-based pulmonary rehabilitation (control group). each subject will be consented and trained and then participate in either the intervention or control group. both groups entail one week of baseline and twelve weeks of home-based pulmonary rehabilitation (health coaching plus activity monitoring). the intervention group will also receive the mindful breathing module during the twelve weeks of home-based pulmonary rehabilitation. the chronic respiratory disease questionnaire (crq) will be administered at baseline, week 12 (after the intervention) and week 24 as the investigators will follow the patients for 3 months after the intervention to document the sustainability of the effects (behavior change).

Eligibility criteria:
inclusion criteria: * patients must be ≥40 years old * patients must have a diagnosis copd documented by pulmonary function testing; breathlessness of score 2 or higher by the medical research council score * patients must be a current or previous smoker with at least 10 pack-years of cigarette smoking exclusion criteria: * patients with a high likelihood of being lost to follow-up or contact (patients with active chemical dependency), are planning to move out of the state; or are not living in the healthcare area * patients with an inability to provide good data or follow commands (patients who are disoriented, have a severe neurologic or psychiatric condition) * patients with an inability to do mild exercise (patients who have orthopedic-neurologic problems; patients who have severe heart failure, characterized by an ejection fraction of \<20% or by new york heart association class iv disease; patients who should be at complete rest, confined to a bed or chair; or patients in whom any physical activity brings on discomfort and in whom symptoms occur at rest).
lidocaine and tetracaine cream to treat postherpetic neuralgia (phn)

Conditions: Postherpetic Neuralgia

Summary: pliaglis™ (lidocaine and tetracaine) cream 7%/7% is a topical local anesthetic cream that forms a pliable peel on the skin when exposed to air. when applied to intact skin, pliaglis provides local dermal analgesia by the release of lidocaine and tetracaine from the peel into the skin. pliaglis is currently approved in the united states for use on intact skin in adults to provide topical local analgesia for superficial dermatological procedures such as dermal filler injection, pulsed dye laser therapy, and facial laser resurfacing. this study will evaluate lidocaine and tetracaine cream 7%/7% for the treatment of pain associated with postherpetic neuralgia (phn).

the objectives of the study are 1) to compare the clinical efficacy of lidocaine and tetracaine cream 7%/7% with placebo cream in the treatment of neuropathic pain associated with postherpetic neuralgia (phn) and 2) to monitor the nature and frequency of adverse events following a single, 60-minute application of lidocaine and tetracaine cream 7%/7% and placebo cream.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of phn. * painful phn areas not located on the face, eye, or in the hair. * at least 3 months post-vesicle crusting. exclusion criteria: * has broken skin at the target treatment site. * is currently on certain prescription medications. * doesn't meet criteria due to physical exam findings or medical history. * female that is pregnant, breastfeeding, or of childbearing potential and not practicing adequate birth control.

Keywords: pain postherpetic neuralgia
stories to educate patients with ankle, foot, and knee injuries

Conditions: Injury

Summary: study will test the use of narratives on patient satisfaction and translation of an evidence-based approach to the use of x-rays for leg injuries in the emergency department (ed). the investigators will identify patients with foot, ankle, or knee injuries for whom x-rays are determined to not be needed. on discharge, patients will receive the current fact-based sheet or that plus a narrative explaining the work-up and treatment of these injuries. outcomes will be assessed by a survey measuring patient satisfaction and understanding.


Eligibility criteria:
inclusion criteria: * acute traumatic knee, ankle or foot injury presenting to ed * no indication for x-ray by ottawa rules criteria * ed provider planning to discharge patient exclusion criteria: * x-ray obtained * need for x-ray by established ottawa rules criteria * children * pregnant women * patient to be admitted to the hospital * patient non-english speaking or illiterate

Keywords: acute lower extremity not requiring diagnostic imaging
postoperative pain after caesarian section

Conditions: Pain, Postoperative; Pruritus; Nausea and Vomiting Following Administration of Anaesthetic Agent; Consumption

Summary: to examine if perioperative pain/nausea/pruritus is altered when current standard analgesia for caesarian section (cs) is replaced with new guideline recommended analgesia.

control group (current analgesia, elective cs) is compared to current analgesia for emergency cs, and guideline recommended analgesia. current analgesia for cs: spinal hyperbaric bupivacaine 5 mg/ml, 9-11 mg. spinal fentanyl 10-15 ug. postoperative: paracetamol 1g x 4, ibuprofen 400 mg x 4 po, oxycodone 10 mg (\ 70 kg) x 2 po, additional oxycodone 2,5 mg iv/5 mg po when needed. guideline recommended analgesia for cs: spinal hyperbaric bupivacaine 5 mg/ml, 9-11 mg. spinal fentanyl 12,5 ug. spinal morphine 0,05 mg. after delivery of baby: dexamethasone 8 mg iv, paracetamol 1g iv, parecoxib 40 mg iv. postoperative: paracetamol 1g x 4, ibuprofen 600 mg x 4 po, oxycodone 2,5 mg iv/5 mg po when needed.

Eligibility criteria:
inclusion criteria: - healthy parturient, term pregnancy, undergoing caesarian section exclusion criteria: * patient refusal * maternal heart or lung disease (not including mild asthma) * known or suspected obstructive sleep apnoea syndrome * pre-eclampsia * body mass index \> 40 * indulin-dependent diabetes mellitus * contraindications to ibuprofen, dexamethasone or morphine * chronic pain * neurological disease * drug abuse * age \< 18 years * american society of anesthesiologists (asa) 3 * patients receiving other forms of anaesthesia (epidural or general)
nail versus sliding hip screw for trochanteric hip fractures

Conditions: Hip Injuries

Summary: the investigators therefore propose to undertake a further randomised controlled trial comparing the sliding hip screw (shs) with the targon pft intramedullary nail. the aim is to see if the summation of the first trial of 600 participants comparing the sliding hip screw with the targon pf nails, in conjunction with this study of 400 participants with the updated targon pft nail produces results that convincingly demonstrate that this particular design of implant is superior to the sliding hip screw. because of the financial issues involved a cost benefit comparison for the two procedures is planned at the completion of the study. primary outcome measures will be regain of walking ability. secondary outcome measures recorded with include mortality, length of surgery, operative blood loss, blood transfusion, post-operative complications, hospital stay, need for subsequent revision surgery and degree of residual pain.

the trial will be run as close to the ideal trial methodology for a randomised trial as specified by the consort statement as possible. this will include secure randomisation, intention to treat analysis, full reporting of outcomes and follow-up by a person who is blinded to the prosthesis used. the trial will follow the code of good clinical practice as specified by the hospital trusts research and development committee. in peterborough all hip fracture patients are admitted to the acute trauma ward and transferred to the care of mjp. those patients that are willing to participant in one of our randomised trials are consented prior to surgery. treatment follows standard evidence based protocols with follow-up of all patients in a hip fracture clinic. a comprehensive database is maintained for all patients containing both audit and research data. included in this is a standardised assessment of outcome. the sliding hip screw used if of a standard design that has been in use at peterborough for the last fifty years. the intramedullary nails used will be the targon pft nail. this nail is very similar to the targon pf nail used in the earlier trial on this topic. bases on the results of the previous study and the experience of other users the nail has undergone minor modifications that are primarily aimed at making the nail easier to use with improved instrumentation and also a change to design of the cross screw aimed at reducing the risk of fracture fixation complications occurring.

Eligibility criteria:
inclusion criteria: * all patients admitted to peterborough district hospital with a trochanteric hip fracture that is to be treated by internal fixation. exclusion criteria: * patients who decline to participate * patients without the capacity to give informed consent * patients admitted when mjp is not available to supervise treatment * patients with pathological fractures from paget's disease of bone secondaries from tumour
pediatric delirium screening in the picu via eeg

Conditions: Delirium

Summary: delirium in the pediatric intensive care unit (picu) is a serious problem that has recently attracted much attention. this study will evaluate the use of electroencephalogram (eeg) for delirium screening in the picu.

primary objective: in a prospective cohort of children hospitalized in a picu, eeg features associated with pediatric delirium (via veegix) will be identified and the diagnostic value to accurately detect delirium of these features will be calculated. secondary objective: to investigate the accuracy and rapidity of delirium diagnosis with the veegix.

Eligibility criteria:
inclusion criteria: eligible for inclusion children 1) \<18 years; and 2) admitted to the picu at the centre hospitalier universitaire ste-justine (chusj). to select patients at high risk for delirium, one of the following inclusion criteria will be needed: 3) mechanically ventilated patients; or 4) non-invasively ventilated patients (bipap, cpap or high flow nasal cannula); or 5) patients receiving opioids; or 6) patients receiving benzodiazepines. exclusion criteria: children 1) suspected of being brain death at the time of picu entry (glasgow coma scale (gcs) 3 and loss of all brain stem reflexes); 2) with significant clinical developmental delay (based on clinical assessment and/or parental report of developmental problems that affected the child's behavior or ability to communicate; pediatric cerebral performance category ≥4); 3) planned discharge from the picu the same or next day.