Kornimate/medical-research-clean huggingface dataset:
efficacy and safety of catheter ablation of atrial fibrillation in patients with thyroid hormone stabilization

Conditions: Atrial Fibrillation and Flutter; Hyperthyroidism; Hypothyroidism

Summary: patients with hyperthyroidism or hypothyroidism are often combined with atrial fibrillation, but after the stabilization of thyroid hormone levels after treatment, the patients' atrial fibrillation still persists. radiofrequency ablation of the atrial fibrillation as one of the treatment options for atrial fibrillation has been widely used in the clinic, and has significant efficacy in maintaining sinus rhythm, improving cardiac function, and improving the prognosis of patients. however, there is a lack of clinical monitoring data on radiofrequency ablation of atrial fibrillation in patients who have combined thyroid dysfunction and have stabilized their thyroid hormone levels after treatment.

in patients recommended by guidelines for atrial catheter radiofrequency ablation of atrial fibrillation, catheter radiofrequency ablation was performed after exclusion of contraindications, and was observed and compared between patients with comorbid pre-existing thyroid hormone disorders and patients without comorbid atrial fibrillation after radiofrequency ablation:1: time to sexual rhythm maintenance: incidence of cardiac-related complications and incidence of noncardiac-related complications within 3 months and 1 year,2: walking distance on a six-minute walk test within 3 months,1 year, comparison of percent left ventricular ejection fraction, and comparison of left ventricular diastolic diameter at the time 3 months,1 year,.to comprehensively assess the efficacy and safety of catheterized radiofrequency ablation of atrial fibrillation in patients with comorbidities of prior thyroid hormone disorders.

Eligibility criteria:
inclusion criteria: atrial fibrillation requiring catheterized radiofrequency ablation （class i recommendation） exclusion criteria: atrial fibrillation requiring catheterized radiofrequency ablation class i recommendation with coexisting contraindications

Keywords: atrial fibrillation and flutter hyperthyroidism hypothyroidism catheter radiofrequency ablation
the effect of cpc on aborting tilt induced syncope in patients with a history of vasovagal syncope or near syncope

Conditions: Syncope, Vasovagal

Summary: syncope is defined as transient loss of consciousness associated with inability to maintain postural tone with rapid and spontaneous recovery. the purpose of this study is to assess the effects of sublingual administration of a new medication called cpc on tilt-induced syncope in patients with a history of vasovagal syncope (vvs) or near syncope. 140 participants will be randomized at the university of wisconsin - madison. each participant will be in the study for 1 day.

vasovagal syncope (vvs) is the most common type of syncope. the mechanism is reflex-mediated triggered by various afferent input to the brain. the event is usually preceded by diaphoresis, warmth, nausea, and pallor, and is followed by fatigue. while several drugs are indicated in the treatment of vvs, to our knowledge, there is no current treatment of an impending syncopal attack. in the present study, the investigators hypothesized that a single administration of sublingual cpc preparation during the prodromal phase would abort tilt-induced syncope or near syncope with sbp less than or equal to 70 mmhg in patients with a history of vvs. patients with an established diagnosis of typical vvs or near syncope will be randomized to receive cpc or placebo in 1:1 ratio. drug or placebo will be administered at the onset of prodromes during tilt table testing. in addition to the primary endpoint (syncope or near syncope with sbp less than or equal to 70 mmhg), the investigators will be assessing the effects of the drug on time to event, incidence of asystole (\> 3 sec), and fatigue after syncope.

Eligibility criteria:
inclusion criteria: 1. established diagnosis of typical vasovagal syncope or near syncope 2. age 18-50 years exclusion criteria: 1. systolic bp \>130 mmhg 2. history of hypertension or cardiac arrhythmias 3. history of cardiovascular disease or cerebral ischemic events 4. allergic reaction to any of the drug components 5. contraindication to tilt testing 6. any physical or psychological symptom, based on the clinical judgment of the investigators that would make a participant unsuitable for the study 7. any use of a medication(s) based on the clinical judgment of the investigators that would make a participant unsuitable for the study (e.g. fludrocortisone, theophylline, prazosin, doxazosin, terazosin, mao-inhibitors, pseudoephedrine, decongestant and pde5 inhibitors). 8. unwilling to discontinue midodrine or beta-blocker therapy 48 hours before tilt table testing. 9. women who are pregnant (confirmed with pregnancy test on day of study) or lactating.

Keywords: neurocardiogenic syncope reflex syncope fainting spells
evaluation of dex-in during outpatient procedures

Conditions: Pain

Summary: the primary objective of this study is to evaluate the analgesic efficacy of dex-in compared with placebo and active control (fentanyl), in subjects undergoing painful outpatient and office based procedures.


Eligibility criteria:
inclusion criteria: * voluntarily provide written informed consent * be planned to undergo a selected office-based or outpatient procedure * be naïve to the planned procedure, i.e. no repeated or revision procedures * not pregnant or planning to become pregnant, or using appropriate contraceptive measures. exclusion criteria: * known allergy to any study treatment or excipient * have another painful physical condition or anxiety related diagnosis that may confound study assessments * evidence of a clinically significant finding on physical examination, laboratory assessment, or ecg * have signs or a history of significant nasal condition that may interfere with intranasal drug delivery

Keywords: peri-procedural pain pain anxiety analgesia anxiolysis
duloxetine for postoperative pain of laparoscopic cholecystectomy

Conditions: Pain, Postoperative

Summary: recent studies on the impact of perioperative duloxetine for treatment of acute postoperative pain have yielded positive outcomes with respect to reduction opioid consumption. the aim of the present study is to investigate the role of perioperative duloxetine on the management of postoperative pain in patients undergoing lc.


Eligibility criteria:
inclusion criteria: * 1. patients who are scheduled to undergo elective lc exclusion criteria: 1- patients with acute pancreatitis 2. patients undergoing chronic pain treatment 3. patients who received analgesics or sedatives 24 h before scheduled surgery 3. patients had alcohol or drug addiction 4. severe hepatic and renal dysfunction 5. previous allergic response to duloxetine 6. pregnancy and lactation 7. patients with communication problems, cognitive dysfunction, or psychological disorders
to evaluate the safety and efficacy of pregabalin in patients with painful diabetic peripheral neuropathy.

Conditions: Diabetic Neuropathy, Painful

Summary: to evaluate the safety and efficacy of pregabalin in patients with painful diabetic peripheral neuropathy.


Eligibility criteria:
inclusion criteria: * must have met the inclusion criteria for the preceding double-blind bid study in painful diabetic peripheral neuropathy * must have received pregabalin/placebo under double-blind conditions for a minimum of 3 weeks. exclusion criteria: * patients may not participate if they experienced a serious adverse event during the preceding double-blind bid study which was determined to be related to the study medication.
analgesia after video-assisted thoracic surgery

Conditions: Post Operative Pain

Summary: although less invasive, postoperative analgesia remains challenging in patients undergoing uniportal video-assisted thoracic surgery (vats).

although less invasive, postoperative analgesia remains challenging in patients undergoing uniportal video-assisted thoracic surgery (vats). adequate postoperative pain relief is imperative to hasten functional recovery, accelerate discharge from the hospital, and reduce chronic postsurgical pain.

Eligibility criteria:
inclusion criteria: * patients scheduled for uniportal vats under general anesthesia, asa status i-iii, aged from 18 to 70 years old of both sex. exclusion criteria: * contraindications to regional block * pregnancy * body mass index (bmi) \> 30 kg/m2 * psychiatric diseases * severe renal, liver, or cardiac dysfunction
slow initial β-lactam infusion with high-dose paracetamol to improve the outcomes of childhood bacterial meningitis

Conditions: Bacterial Meningitis

Summary: the main purpose of this trial is to test if mortality of childhood bacterial meningitis can be reduced by slow, continuous infusion of cefotaxime initially, instead of the traditional bolus administration four times daily (qid), combined with high-dose paracetamol orally, when both treatments are executed for the first 4 days. the series will be collected at hospital pediátrico david bernardino, luanda, angola. the recruitment of patients begins, the conditions permitting, in early 2012. the criteria for patient participation is a child at the age of 2 months to 15 years who presents with the symptoms and signs suggestive of bacterial meningitis, for whom a lumbar puncture is performed, and the cerebrospinal fluid analysis suggests bacterial meningitis.

the principal objective of the study is to examine if mortality of childhood bacterial meningitis can be reduced by slow continuous infusion of cefotaxime combined with high-dose paracetamol orally for the first 4 days (instead of the traditional qid administration of cefotaxime without concomitant paracetamol). children qualifying for entry (see criteria below), whose guardian has given informed consent,will be randomized into 2 treatment arms (see details below)and receive the treatments in a double blind fashion (see details below). primary and secondary outcomes (detailed below) will be evaluated according to predefined criteria and time points (see below). results will be analyzed for all patients in itt datasets and in prespecified subgroups (etiology, nutritional status, etc.) in both crude and adjusted analysis. the efficacy results will be expressed as or with 95% confidence intervals.

Eligibility criteria:
eligibility criteria: the study entry is assessed for all children at age 2 months - 15 years who present at these centers with the symptoms and signs suggestive of bacterial meningitis (bm), and to whom lumbar puncture is performed. inclusion criteria: all patients whose cerebrospinal fluid (csf) turns out to be cloudy, positive by gram staining or latex agglutination, or shows at least 50 leukocytes per mm3, will be enrolled in the study. participants: exclusion criteria exclusion criteria: 1. trauma, or relevant underlying illness such as intracranial shunt, previous neurological abnormality (cerebral palsy, down's syndrome, meningitis) 2. previous hearing impairment (if known) 3. immunosuppression, except hiv infection 4. more than one parenteral dose of a pretreatment antimicrobial. children with oral antimicrobials are included, this information being marked in the follow-up sheet. 5. active tuberculosis (if tuberculotic meningitis is diagnosed during trial, it will be included in intention-to-treat (itt) analysis) 6. known hepatic disease.

Keywords: bacterial meningitis infusion bolus paracetamol
efficacy of nebido on bone mineral density (bmd) in hypogonadal paraplegic patients with confirmed osteoporosis

Conditions: Hypogonadism; Paraplegia; Bone Density; Osteoporosis

Summary: both conditions hypogonadism and immobilisation (paraplegia) may contribute or lead to decreased bone mineral density resp osteoporosis. in this study bone mineral density is assessed in hypogonadal paraplegic patients, who are on standard prophylactic therapy for osteoporosis and and on a standard physiotherapy exercise program one group receiving nebido for testosterone replacement (trt). the additional effect of trt on bone mineral density / osteoporosis is assessed (ct scan lumbar spine).


Eligibility criteria:
inclusion criteria: * male patients \> 18yrs * osteoporosis prophylaxis/therapy with * vitamin d 800 - 1200 mg per day, * calcium 800 - 1000 mg per day, * fosamax 70 once a week. * standardised physiotherapy exercise programme. * no proliferative bone disease. * no history of calcium oxalate stones. * no use of aromatase inhibitors. * no use of 5-alpha reductase inhibitors. nebido group: * no contraindications to use of nebido (known prostate or breast carcinoma or suspicion thereof, no past or present history of liver tumours); * no known hypersensitivity to testosterone or excipients of nebido exclusion criteria: * androgen dependent carcinoma of the prostate or male mammary gland, past or present history of liver tumours, hypersensitivity towards the active pharmaceutical ingredient or other ingredients.

Keywords: testosterone replacement therapy hypogonadism osteoporosis immobilisation paraplegia testosterone
cost-consequence analysis of influenza vaccination in a teaching hospital in rome

Conditions: Influenza Vaccine; Cost-Benefit Analysis

Summary: flu vaccination, as well as being effective to prevent seasonal influenza, decreases staff illness and absenteeism and reduces costs resulting from loss of productivity. despite the effectiveness of flu vaccination, the seasonal coverage among healthcare workers is usually low. the aim of this retrospective observational study is to analyze the vaccination coverage rate among all employees (healthcare workers and administrative staff) of a large teaching hospital in rome during the 2017-2018 influenza season, to perform a cost-consequence analysis of influenza vaccination (by evaluating the absenteeism due to illness in the epidemic period), and to assess the impact of vaccination in terms of both costs and sick days.


Eligibility criteria:
inclusion criteria: • healthcare workers at fondazione policlinico universitario "a.gemelli" irccs exclusion criteria: • healthcare workers not working at fondazione policlinico universitario "a.gemelli" irccs
brain morphometry in oa patients treated with duloxetine

Conditions: Pain; Osteoarthritis

Summary: this is a two week,single-blind study evaluating pain response and changes in brain imaging upon treatment with placebo in people with knee oa.

in this study, all the participants will be receiving placebo. however this study will be single blinded in that participants will be told that they will be given a pill that may or may not help with their pain. the researcher, however, will know that all participants are receiving placebo at the initial visit, participants will undergo screening to determine that they meet all inclusion and exclusion criteria. they will sign consent and then complete pain assessment instruments as well as one high resolution anatomical scan (t1) and one functional scan (a resting scar) in a 3 tesla magnet. a single scanning session comprised of a 10 minute functional scan (a resting scan) will be done two weeks from the first scan and pain assessment instruments will be completed at this visit as well. after finishing this second scan (done two weeks after the initial scan), the participants will have completed the study.

Eligibility criteria:
inclusion criteria: * age: 40-85 years * acr criteria for oa including kellgren-lawrence radiographic oa grades ii-iv * vas pain score \>5/10 within 48 hrs of the phone screen and visit 1 (screening) * knee oa for a minimum of 12 months * need for daily pain medication to manage symptoms of oa exclusion criteria: * currently taking mao inhibitors or any centrally acting drug for analgesia * narrow angle glaucoma * uncontrolled hypertension * co-existing inflammatory arthritis, fibromyalgia or other chronic pain state * if a female, pregnant, trying to become pregnant, or lactating * major depressive disorder * substantial alcohol use or history of significant liver disease * diabetes, type 1 or type 2 * condition in which the investigator believes would interfere with the subject's ability to comply with study instructions, or might confound the interpretation of the study results or put the subject at undue risk * standard mri safety exclusions

Keywords: placebo pain osteoarthritis
experiments to test how and why the sense of smell differs between people

Conditions: Specific Anosmias

Summary: the ability to smell varies greatly between different individuals. some people are unable to detect an odor that most people can smell. it is not known what causes these individual differences. humans have about 1000 genes for odorant receptors that bind and detect odor molecules. it has been shown that some of these genes exist in two forms: a functional one and one that has been mutated and is therefore no longer functional. we think that people who can not smell a specific odor may carry the non-functional form of the gene for the receptor that detects the odor molecule. to test this hypothesis we want to find people who can not detect a specific smell and then compare their odorant receptor genes with those of people who can smell the odor.

the enjoyment of a fine wine, the odor of a ripe cheese, the memory of a long-lost grandmother brought back by the scent of her perfume, or the alarm we feel when we smell smoke are all produced by a functioning olfactory system. interestingly, there are enormous individual differences in how we interpret these smells. given almost any odor, some people will find it pleasant, others unpleasant. ripe cheese or garlic may smell delicious to some, but repulsive to others. the scientific basis of this variation has not been well-studied. despite the clear evidence for culture-based preferences for food and aromas, the nature-versus-nurture debate for smell remains unresolved. we believe there may be a genetic basis for our unique senses of smell. for example, some of us can smell methanethiol, the metabolite that is excreted in our urine after eating asparagus, whereas other people cannot. the rockefeller university smell study seeks to recruit 400 normal subjects to track down the genetic basis of how we perceive smells. the study consists of up to two visits, each lasting up to 4 hours, in which we will test your perception of a variety of smells. on your first visit there will be a small blood sample taken (8.5 millileters) and your height and weight will be measured. if you are a woman of child-bearing age, we will ask you to provide a urine sample to test for pregnancy. if you are pregnant, you will not be permitted to participate in our study. you will fill out a short survey that asks some questions about yourself, your household, your personal habits, and your sense of smell. you will perform three different types of smell tests. in the first, you will be given two vials at a time and asked to tell us which contains an odor. in the second type of test, you will be asked to describe carefully your impression of three different odors. in the third type of test, you will be asked to rate odors according to their strength and pleasantness. all odorants will be presented to you in glass jars. you will be asked to smell odors in several hundred jars.

Eligibility criteria:
inclusion criteria: 18 years or older, male and female normal sense of smell - exclusion criteria: not pregnant no history of nasal illness or surgery no seasonal allergies-
eswl vs urs in management of upper third ureteric calculi

Conditions: Ureteral Stones

Summary: comparative study of two treatment modalities (ureteroscopy and extracorporeal shock wave lithotripsy) in management of upper third ureteral calculi

large impacted upper ureteral calculus is defined as a stone located above the lower border of the fourth lumbar vertebra, remaining fixed at the same site for at least six weeks. moreover, it is associated with hydronephrosis and/or prevents contrast medium from passing below the calculus on intravenous urography (ivu).moreover, there is inability to pass a guidewire or catheter beyond the stone at initial attempts. the treatment for patients with large impacted proximal ureteral stone remains controversial; the surgical options for the treatment of proximal ureteral stones include extracorporeal shockwave lithotripsy (eswl), ureteroscopy, pcnl and rarely laparoscopic or open surgery. every technique has its own limitations. the aim of this study is to compare and to evaluate the outcome and complications of two main treatments procedures for impacted proximal ureteral calculi, extracorporeal shock wave lithotripsy (eswl) and ureteroscopy. extracorporeal shock wave lithotripsy (eswl) and ureteroscopy are two common modalities in the management of proximal ureteral calculi.european association of urology (eau) and american urological association (aua) guidelines have recommended urs or eswl as first-line treatment options.eswl is an effective and non-invasive treatment method in urolithiasis, particularly in stones located in the upper third of the ureters.however, urs is a more invasive technique when compared to eswl, urs became the most efficient treatment method in proximal ureteral calculi after the development of small-caliber, semi-rigid and flexible endoscopes and the holmium:yag laser. today, the greatest dilemma faced by urologists is to choose between eswl and urs. a number of factors influence the final results of eswland if no fragmentation occurs after several unsuccessful sessions, the stone is considered eswl-resistant; the case is deemed an eswl-failure and the patient therefore undergoes urs.urs has been described as a salvage or second line treatment option in cases of eswl-resistant calculi

Eligibility criteria:
inclusion criteria: - the study will include patients in the age group of 18-70 years with body mass index of less than or equal to 30 kg/m2 with upper ureteral calculi more than or equal to 1 cm with density about 900 - 1100 hu exclusion criteria: * patients with distal obstruction * impacted stones : an impacted stone is defined as a stone where a guidewire will not pass without ancillary measures and/or a stone that does not move when forceful irrigation is applied ureteroscopically * marked hydronephrosis : gross dilation/ballooning of the renal pelvis and calyces with loss of borders between the renal pelvis and calyces and renal atrophy seen as cortical thinning * radiolucent stones * pregnancy * stones in children * spinal deformity * morbid obesity * patients on aspirin