Kornimate/medical-research-clean huggingface dataset:
effects of different types of anesthesia on stress response in laparoscopic gastric bypass for type 2 diabetes mellitus

Conditions: Diabetes; Stress; Anesthesia

Summary: general anesthesia can be considered as a combination of hypnosis, antinociception and immobility. explore the effect of three kinds of anesthesia,that is the total intravenous anesthesia, inhalation anesthesia and inhalation and intravenous anesthesia on stress reactions generated by patients with diabetes conducted gastric - bypass surgery , and choose a best way from three kinds of anesthesia to control stress reaction of diabetics. after selecting the appropriate anesthesia method, assess the effect of dexmedetomidine on controlling stress response from diabetics undergoing laparoscopic gastric-bypass surgical.

research content and indicators 1. preparation of serum: 3ml of blood were taken before induction of anesthesia (after entering the operating room), surgery began 1h, surgery began 2h, 24h after surgery, and placed at dry tube, centrifuged for 10min at 3000g after placing at room temperature for 2h , the resulting supernatant was subpassaged in tube, stored at -20℃ until analysis. 2. indicators to detect in serum contained tumor necrosis factor-α, interleukin-6, interleukin-10, plasma glucose, cortisol,insulin and c-peptide. 3. record the vital signs.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists（asa）ⅰ \~ ⅱpatients * type 2 diabetes mellitus patient undergoing laparoscopic gastric bypass surgery * between 18 and 60 years of age exclusion criteria: * a history of cardiopulmonary disease, liver and kidney dysfunction, abnormal coagulation * thyroid disease

Keywords: diabetic laparoscopic gastric bypass surgery stress response anesthesia dexmedetomidine
effectiveness of an e-mail tracking intervention among the continued abstinence of tobacco consumption

Conditions: Tobacco Dependence; Cessation of Smoking

Summary: objectives. to evaluate the effectiveness and cost effectiveness of clinical practice guide based intervention with two face-to-face visits and e-mail tracking compared to brief advice to obtain continued smoking abstinence at 6 and 12 months after intervention. methodology. simple randomized controlled multicentric trial. all smokers (n=1064) aged 18 or older that attend by any reason to the primary care center and that have an e-mail account and they checked it at least once a week will be invited to participate. the enrolled participants will be randomly divided into control (n=532) and intervention group (n=532). an intensive intervention, based on the recommendations of the clinical practice guides, that will include six contacts (2 face-to-face and 4 by e-mail) will be applied to the intervention group. control group will receive brief advice. the main dependent variable will be continued abstinence of tobacco consumption at six and twelve months after the beginning of the intervention which will be validated by and a carbon monoxide breathe analysis measured by a cooximeter in standard conditions. secondary variables will include: stage change on the quitting smoking process and evaluation of the effectiveness on the reduction of the number of smoked cigarettes at six and twelve months after intervention. a descriptive analysis of all variables will be done. a multivariate analysis will be undertaken to assess differences among intervention and control group; logistic regression for dichotomic variables and lineal regression for continuous variables.

in preliminary phase is planned to carry out 2 descriptive sub-studies: a qualitative one, which will reflect the views of patients and physicians regarding the use of email as a smoking cessation intervention, and another smoker's profile in relation to information and communication technologies (ict), which collects information on the actual use of them in smokers. the result of both will help to release data on the type of participants who would be involved in the clinical trial.

Eligibility criteria:
inclusion criteria: * smokers over 18 years old with an e-mail account who use frequently. (smoker is an individual who smokes any amount of tobacco, whatever this amount it is. * e-mail regular user is the one who uses it as a way of communication at least once per week) exclusion criteria: * not regular e-mail users, * patients who have diseases that advise not to stop smoking: * terminal diseases * serious psychiatric disorders * active addiction to other psychoactive drugs * patients in smoking cessation process * whatever the cause that does not allow to understand goals and methodology of the study

Keywords: adult computer-assisted instruction electronic mail program evaluation smoking cessation/methods continued abstinence
liposomal bupivacaine versus interscalene nerve block

Conditions: Pain, Postoperative

Summary: the aim of this study is to compare two different pain management interventions in patients undergoing reverse total shoulder arthroplasty. the two interventions are 1) pre-operative interscalene nerve block and 2) intraoperative injection of liposomal bupivacaine (exparel, pacira pharmaceuticals, parsippany nj). specifically, the primary aims of this study are to compare these two interventions on the following: post-operative opioid consumption, pain scores, and patient satisfaction. additionally, the investigators want to determine if psychological factors, catastrophizing and resilience, are associated with post-operative pain control and satisfaction. the investigators' hypothesis is that the two interventions will have similar pain control efficacy and that the liposomal bupivacaine group will experience faster post-operative recovery, earlier discharge, and improved satisfaction. the investigators also expect patient catastrophizing and resilience to significantly predict the degree of post-operative pain and level of patient satisfaction.


Eligibility criteria:
inclusion criteria: * patients who are older than 18 years * patients undergoing reverse total shoulder arthroplasty exclusion criteria: * pregnancy * inability to provide informed consent * deemed unreliable for follow-up survey completion * individuals who do not speak english * those who have an allergy to the study medications (ropivicaine, bupivicaine) or have clinically significant hepatic disease
immunodysregulation as an expression of underlying inborn errors of immunity: implementation of diagnostics and management of pediatric and adult patients with immune system disorders

Conditions: Inborn Errors of Immunity

Summary: this is an observational, retro-prospective, moncentric study focused on inborn errors of immunity, an heterogeneous group of inherited diseases due to defects in the differentiation and/or function of the immune system. the primary aim of this study is to obtain a clinical-immunological, functional and molecular characterisation of paediatric and adult patients with confirmed or suspected inborn errors of immunity, particularly of patients with manifestations of immunedysregulation, focusing on clinical course, immunophenotypic laboratory and functional abnormalities, genetic background.

due to the observational nature of the study, patients were and will be treated according to normal clinical practice and in accordance with medical judgement. the following evaluations were performed in the retrospective cohort and will be performed in the prospective cohort: * standard haematochemical examinations; * extended lymphocyte typing; * plasma dosage of immunoglobulins; * evaluation of early and late responses to measles-parotitis-rosolia and diphtheria-tetanus-pertussis vaccinations; * evaluation of antibody responses to vaccines against haemophilus influenzae, neisseria meningitidis and pneumococcus; * detection of auto-antibodies on hep-2 cells, and of auto-antibodies directed against haemopoietic cells and proteins of innate and adaptive immunity; * plasma dosage of complement factors (c3, c4); * radiological assessment; * functional immunological assay; * molecular-genetic investigations of targeted gene panels involved in immunodysregulation and inborn errors of immunity.

Eligibility criteria:
inclusion criteria: * patients with confirmed or suspected inborn errors of immunity; * age \< 50 years at onset of clinical features suspected for inborn errors of immunity; * obtaining informed consent from patients or parents/legal guardian of pediatric patients. exclusion criteria: • patients in whom infectious susceptibility and immunodysregulation can only be attributed to known non-immunological causes: acquired immunodeficiency secondary to chronic infections (hiv), and acquired immunodeficiency secondary to immunosuppressive treatment.

Keywords: inborn errors of immunity
efficacy of extended-release liposomal bupivacaine for post-operative urogynecologic surgery

Conditions: Postoperative Pain

Summary: to study post-operative efficacy of exparel® for pain control in patients undergoing any urogynecology surgery involving the posterior vaginal wall using a randomized, double-blinded placebo controlled trial.

effective post-operative pain management is a crucial component of a patient's surgical course following urogynecologic surgery. narcotics are the cornerstone for post-operative analgesia with a frequent re-dosing requirement, a lengthy list of side effects and adverse reaction risks5. the colorectal, orthopedic and general surgery literatures have reported on an extended-release bupivacaine liposomal injection, exparel®, which remarkably reduces acute post-operative pain; however, this medication has not yet been reported within urogynecology literature. we propose a prospective, randomized, double blind, placebo controlled trial with 120 subjects recruited from the wrnmmc urogynecology clinic to study post-operative efficacy of exparel® for pain control in patients undergoing urogynecology surgery involving the posterior vaginal wall. subjects will be randomized to receive either 20ml of extended-release bupivacaine or 20ml placebo. the primary objective of the trial will be to evaluate the cumulative post-operative vaginal pain using front side of defense and veterans pain rating scale16 at days 1 and 3 post-procedure.. we hypothesize a 30% difference in post-operative pain measurements between the active medication group and placebo group. additional objectives of this study are to evaluate vaginal pain on post-operative day 7, total medication usage on days 1, 3 and 7 and any post-operative voiding dysfunction, comparing the study group to the control.

Eligibility criteria:
inclusion criteria: females \>18 years of age undergoing urogynecologic surgery involving the posterior vaginal wall mucosa or muscularis (including but not limited to posterior colporrhaphy, colpocleisis, sphincter repair, sphincteroplasty, perineoplasty) at walter reed national military medical center. patients must be able to read and understand written english or have an appropriate certified medical translator available. exclusion criteria: known allergy to amide local anesthetics unstable cardiac arrhythmia hepatic impairment (including but not limited to patients under the care of their physician for severe hepatic disease, cirrhosis or hepatic cancer) known pregnancy at time of surgery (pregnancy test morning of surgery if applicable) regular use of narcotic pain medication, defined as use on most days of week at any time in the three months prior to surgery significant history of opioid or alcohol abuse or addiction (requiring treatment) concurrent pain management requiring the use of epidural anesthesia
botox® (botulinum toxin type a) as headache prophylaxis in chinese participants with chronic migraine

Conditions: Migraine Disorders

Summary: this study will evaluate the efficacy and safety of botox® (botulinum toxin type a) compared with placebo as headache prophylaxis in chinese participants with chronic migraine.


Eligibility criteria:
inclusion criteria: * diagnosis of chronic migraine prior to the baseline phase based on the revised criteria for chronic migraine listed in international classification of headache disorders (ichd)-3 beta (2013) * fifteen or more headache days during the 4-week baseline phase, with each day consisting of 4 or more hours of continuous headache * routine non-headache medications of stable dose and regimen for at least 1 month prior to the start of screening. exclusion criteria: * participants diagnosed with any of the following headache disorders: familial hemiplegic migraine, sporadic hemiplegic migraine, migraine with brainstem aura, migrainous infarction, chronic tension-type headache, hypnic headache, hemicrania continua, new daily-persistent headache and recurrent painful ophthalmoplegic neuropathy * participants with a confirmed history of medication overuse headache * participants with a diagnosis of retinal migraine, persistent aura without infarction or migraine-triggered seizure * headache attributable to another disorder (eg, cervical dystonia, craniotomy, head/neck trauma) * use of any headache prophylactic medication within 28 days prior to the start of the screening * any medical condition that may put the patient at increased risk with exposure to botulinum toxin type a, including diagnosed myasthenia gravis, eaton-lambert syndrome, amyotrophic lateral sclerosis, or any other significant disease that might interfere with neuromuscular function * participants with a known or suspected temporomandibular disorder (tmd), including pain in or around the temporomandibular joint (tmj) * participants with a concurrent diagnosis of fibromyalgia * previous treatment with botulinum toxin therapy for any reason, or immunization to any botulinum toxin serotype * acupuncture, transcutaneous electrical nerve stimulation (tens), cranial traction, nociceptive trigeminal inhibition or occipital nerve block treatments, or injection of anesthetics or steroids into the study target muscles within 28 days prior to the start of the screening * unstable liver disease (as defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminaemia, esophageal or gastric varices or persistent jaundice), cirrhosis, known biliary abnormalities (with the exception of gilbert's syndrome or asymptomatic gallstones).
cervical unilateral antero-posterior mobilization and thoracic central postro-anterior mobilization in treatment of shoulder impingement syndrome

Conditions: Shoulder Impingement

Summary: shoulder impingement syndrome (sis) is a complex, multi-factorial problem that is treated with a variety of different conservative options. the conservative option that has shown effectiveness is manual therapy of the cervical and thoracic spine

this study will be conducted to answer the following question: what is the effect of adding cervical and thoracic mobilization to selected therapeutic exercise program on pain intensity, pain-free shoulder flexion and scaption active rom, muscle strength of external rotator and abductors, shoulder functional status in patients with shoulder impingement syndrome

Eligibility criteria:
inclusion criteria: * • patients who had received at least two positive signs on their neer sign, hawkins sign, supraspinatus test, apprehension test, and relocation test * patients report pain on elevating the arm between 70 ° and 120 ° (the "painful arc"), on forced movement above the head, and when lying on the affected side exclusion criteria: * • cervical radiculopathy * a history of shoulder surgery * corticosteroid injection within the past month * subjects who had received physical therapy treatment for their shoulder within the past three months.
effects of whole-body vibration exercise on stroke patients

Conditions: Stroke; Hemiplegia

Summary: the purpose of this study is to investigate the effect of the whole body vibration exercise on cortical activity and gait function in patients with chronic stroke.

whole body vibration exercise can provide proper somatosensory stimulation and improve muscle strength and postural control in stroke patients. however, there has not yet been a report on the cortical activity changes induced by whole body vibration exercise. patients will be randomly assigned to one of the two groups. one group will go through whole body vibration with exercise and the other will only perform exercise. the primary outcome measurement of this study was cerebral cortex activity based on changes in oxygenated hemoglobin concentration using functional near-infrared spectroscopy. behavioral assessments were performed before and after the intervention session using the 10-meter walk test, timed up and go test, fugl-meyer assessment, and tinetti performance oriented mobility assessment.

Eligibility criteria:
inclusion criteria: * unilateral stroke with hemiplegia * 3 months after stroke onset * able to walk at least 10 meters without assistive devices exclusion criteria: * subjects under 18 years and above 80 years old, * unable to perform a half squat on a vibrator (eg. visual field defects, fracture, and severe muscle paralysis) * musculoskeletal disorders * risk of falling due to dizziness * pregnant women

Keywords: whole body vibration exercise
study on clinical features and outcomes of breast sarcoma

Conditions: Breast Sarcoma

Summary: this is multi-institutional retrospective study in order to identify the most relevant clinical characteristics, treatment strategies, to explore the impact on principal clinical outcomes and finally, to suggest some principles for management and treatment of breast sarcomas. the study will collect data about patients affected by breast sarcoma referred to participating institutions between january 2000 and june 2020

in the field of soft tissue sarcomas, breast sarcomas are a truly peculiar family of rare tumors for both their clinical history and biology of disease. surgery (if feasible) is the main therapeutic approach for all the patients with localized disease, while a pharmacological (chemotherapeutic) and/or radiotherapeutic treatment is reserved to those with high-risk/recurrent-relapsing/metastatic disease. unfortunately, there is a lack of specific prospective trials in breast sarcoma to guide the clinical decision-making and breast sarcoma patients are often sent to sarcoma referral centers only after surgery due to sarcoma-specific clinical features, it is clear that both diagnostic and clinical strategies mandate a different approach compared to epithelial tumors. this is of key importance to reach the correct diagnosis, design the best therapeutic decision-making and subsequent follow-up. even if retrospective data limitations and biases, in the lack of prospective data collection, these data may be a unique and precious source of information for this reasons this multi-institutional retrospective study is aimed to identify the most relevant clinical characteristics, treatment strategies, to explore the impact on principal clinical outcomes and finally, to suggest some principles for management and treatment of breast sarcomas.

Eligibility criteria:
inclusion criteria: * \>18 years at diagnosis * primary or secondary breast sarcoma * availability of medical data needed for the study (histopathological data, surgery, chemotherapy, including preceding chemotherapeutic regimens for secondary breast sarcomas, radiation therapy) exclusion criteria: * sarcoma metastases to the breast * chest wall sarcomas not arising in the mammary gland * cutaneous sarcomas
treatment of lateral epicondylitis: platelet rich plasma versus steroid versus saline solution

Conditions: Lateral Epicondylitis

Summary: we wish to address the efficacy and safety of platelet rich plasma (blood platelets), a new treatment for lateral epicondylitis (tennis elbow) and compare this new treatment to either injection with steroid or saline solution. all injections are guided by ultrasonography.

plate rich plasma (prp) is a new treatment for tendinopathy. a high concentration of blood platelets is made from the patients own blod, and then injected into the tendon. the idea is that the complex mixture of growth factors within the platelets can stimulate the healing process of the tendon. we want to address the efficacy and safety of this new treatment and compare it to either the best documented treatment, steroid injection, or to a saline solution. we want to make a randomized controlled trial with 60 participants, 20 in each of the 3 groups, and a 12 months follow up. all injections are guided by ultrasonography.

Eligibility criteria:
inclusion criteria: * duration of tennis elbow \> 6 months * doppler activity on ultrasonography * lateral elbow pain that is maximal over the lateral epicondyle, and increases with pressure on the lateral epicondyle, and resisted dorsiflexion and/or middle finger. exclusion criteria: * inflammatory disease. * fibromyalgia. * pain in hand or shoulder/neck in the same arm as being treated. * anticoagulation treatment. * wounds around the elbow. * treatment with steroids within the last 3 months.

Keywords: lateral epicondylitis tennis elbow epicondylitis lateralis
mdd(mild cognitive impairment delirium dementia) cohort

Conditions: Delirium; Mild Cognitive Impairment; Dementia

Summary: * identify the degree of delirium in subjects with mild cognitive impairment and find the risk factors of delirium. mortality, hospital stay, and medical expenses are analyzed as clinical consequences related to delirium incidence. * dementia conversion rate and conversion period of subjects with mild cognitive impairment with delirium and it identifies the effect of delirium on dementia conversion. * develop an ai(artificial intelligence) algorithm for predicting dementia transition in subjects with mild cognitive impairment based on the research results of the 1st, 2nd, and 3rd years.


Eligibility criteria:
inclusion criteria: * patients 65 years of age or older who are admitted to a ltc * patients diagnosed with mild cognitive impairment by doctors * patients with a score of 18 or more and 23 or less on the mini-mental state examination exclusion criteria: * patients unable to measure the delirium assessment tool, the short confusion assessment methods (s-cam) (inouye, 2014) due to severe vision and hearing problems * patients with serious psychiatric or neurological diagnosis,patients who expire or were transferred on the day of admission - * patients receiving emergency treatment at the time of the delirium assessment or unable to measure or intervene with s-cam due to hospital circumstances

Keywords: delirium mild cognitive impairment dementia