Kornimate/medical-research-clean huggingface dataset:
does early administration of tranexamic acid reduce blood loss and perioperative transfusion requirement

Conditions: Hip Fractures; Intertrochanteric Fractures

Summary: intertrochanteric hip fractures typically result in blood loss from the fracture and require surgery that can cause further blood loss. this study is being done to look at a medication called tranexamic acid which may reduce blood loss and the need for blood transfusions associated with surgery.

the use of txa in orthopedic trauma patients is an area of current research interest. a 2010 prospective randomized, controlled trial of perioperative txa demonstrated reduction in transfusion requirements for intertrochanteric hip fractures treated with short, cephalomedullary nails. this was clinically, though not statistically, significant. investigators recently conducted a randomized, controlled trial at this institution to evaluated the use of txa in patients with femoral neck fractures treated with hemiarthroplasty or total hip arthroplasty and found clinically, albeit not statistically, significant reduction in transfusion requirement (accepted for publication). perhaps tempering the effect seen with perioperative administration of txa is the blood loss that occurs prior to surgery, the so-called "hidden" blood loss that can be as substantial as 1/3 of total blood loss from a hip fracture. this raises the question whether administration of tranexamic acid at the time of initial presentation after fracture could improve the perioperative care of these patients by decreasing the proportion of patients requiring transfusion and decreasing total blood loss.

Eligibility criteria:
inclusion criteria: * ao/ota fracture classification 31a * surgically treated with sliding hip screw or cephalomedullary nail (short or long) * low energy, isolated injury exclusion criteria: * intracapsular hip fractures: ao/ota fracture classification 31b-c * polytrauma patients * creatinine clearance less than 30 ml/min * history of unprovoked vte and/or recurrent vte * known history of factor v leiden, protein c/s deficiency, prothrombin gene mutation, anti-thrombin deficiency, anti-phospholipid antibody syndrome, lupus anticoagulant * pregnancy or breastfeeding (pregnancy tests will be performed on all patients of child-bearing potential) * history of cva, mi, or vte within the previous 30 days * coronary stent placement within the previous 6 months * disseminated intravascular coagulation * intracranial hemorrhage
variation in serum levels of metformin in patients with reduced renal function

Conditions: Diabetes Mellitus Type 2; Metformin; Pharmacokinetics

Summary: metformin is widely used for treatment of type 2 diabetes mellitus. side-effects are few and mainly from the gastrointestinal tract. since metformin is cleared from the blood exclusively via the kidneys reduced renal function is a relative contraindication. we have earlier demonstrated that metformin safely can be used to a lower gfr level of 30 ml/min/1.73. below that level the risk of lactacidosis, a severe complication, increases. in the present study we plan to analyse serum levels of metformin repeatedly in patients with moderate renal failure (ckd = gfr of 30-60 ml/min/1.73). blood samples will be taken as trough values in the morning, week 0, 2, 4, and 8 and at four weeks a blood sample will be taken two hours after intake of the morning dose of metformin. renal function will be estimated with creatinine and cystatin c at each occasion. the intraindividual variation of metformin will be calculated. the study rests on a new method for measuring metformin. the technique uses liquid chromatography tandem mass spectometry (lcmsms). proteins are removed from serum by adding acetonitrile to the sample. after centrifugation a diluted portion of the supernatant is injected into the lcmsms-system. the total runtime for a sample is 6 minutes. the study will show if variation in serum levels of metformin measured in the same patient is high or low and thus give us better understanding whether a change i serum level is due to biological variation or to increased retention caused by progressive renal failure.


Eligibility criteria:
inclusion criteria: * patients above the age of 18 years with type 2 diabetes mellitus. * reduced renal function measured as estimated gfr (below 60 ml/min/1.73). * treatment with metformin on going. exclusion criteria: * severely reduced gfr (\< 30 ml(min/1.73)
early detection of chronic kidney disease

Conditions: Chronic Kidney Diseases

Summary: this retrospective observational study aims to assess the proportion of patients who were appropriately referred from primary care to the nephrology teleconsultation service. the appropriateness of the referral will be determined by the time elapsed between the referral criteria being met and the date of the teleconsultation, as well as by the patient's treatment at the time of referral.


Eligibility criteria:
inclusion criteria: * men and women over 18 years of age * teleconsultation to nephrology from primary care in the garraf region during the period from january to december 2024 * patients with at least one referral criterion for the nephrology service exclusion criteria: participants diagnosed with any of the following conditions: * patients with chronic kidney disease previously evaluated by the nephrology service. * history of requiring renal replacement therapy (hemodialysis, peritoneal dialysis, or kidney transplantation). * patients hospitalized within the last 3 months with a diagnosis of kidney failure. * patients with a known prior diagnosis of autosomal dominant polycystic kidney disease or glomerular diseases.
effectiveness of an intervention bundle on thirst intensity and dry mouth among patients in icus

Conditions: Thirst; Dry Mouth

Summary: the study evaluates the effectiveness of an intervention bundle on thirst intensity and dry mouth among patients admitted in icus. patients were randomized into two groups - experimental and control group. experimental group received intervention bundle whereas control group didn't receive any intervention. usual care was continued in both the groups.

the convenience sampling technique was used to select maharishi markandeshwar institution of medical science and researches hospital, mullana, ambala. intensive care units and a total of 60 patients in those units were also selected conveniently. the selected patients were randomly assigned to experimental and control group using lottery method. the total sample size for the study was 60 patients i.e. - 30 in experimental group and 30 in control group. experimental group -patients were explained regarding administration of intervention bundle.assessment of patients' mouth and lips was determined firstly. intervention bundle consisted of sterile cold wet oral swab wipes and sterile ice cold water sprays administered for in two sessions of 15 minutes each. first session was given in 15 minutes, patients received cold wet oral swab wipes in oral cavity 2 to 3 times and mouth spray with 5 to 6 sprays. a maximum of 9 wipes and 18 sprays of sterile water. after administration of intervention bundle, post test 1 was taken after 15 minutes observation with the same tools. then researcher waited for 15 minutes after post test1 and session two was administered in 15 minutes with a maximum of 9 wipes and 18 sprays of sterile water. post test 2 was taken after 15 minutes of session two. control group: control group was not given any intervention. sample characteristics and clinical data (variables) were recorded in record sheet and thirst intensity and dry mouth scores were assessed only. after 30 minutes of pre test scores, post test 1 was taken and data were recorded. then after, 30 minutes of post test 1, post test 2 was taken and data were recorded. (intervention to the control group was given after accomplishment of post test for ethical consideration).

Eligibility criteria:
inclusion criteria: 1. 18 or above 18 years of age. 2. having thirst score ≥ 5 and dry mouth score ≥ 1 3. willing to participate in the study. 4. able to report verbally or non verbally about thirst intensity. 5. admitted in iccu,respiratory icu, neurosurgical icu and step up icu exclusion criteria: 1. on mechanical ventilation. 2. not able to follow the commands. 3. having any oral surgery 4. having open sores or desquamation of mouth and lips

Keywords: thirst, dry mouth, intervention bundle
comparative effects of dialysate flow rate and membrane packing on the performance of dialyzers used for hemodialysis

Conditions: Chronic Kidney Disease; Chronic Renal Disease

Summary: the purposes of this study are to determine if the performance of a dialyzer depends on how tightly the hollow fiber membranes are packed in the housing of the dialyzer (the membrane packing density) and if that dependence is a function of the dialysate flow rate. the study will examine how efficiently three different sized molecules pass through a dialyzer membrane at different dialysate flow rates in dialyzers with different membrane packing densities. transfer of urea, phosphorus and beta-2-microglobulin from blood to dialysate will be measured during clinical hemodialysis using four different dialyzers, each used at three different dialysate flow rates. the data derived from these measurements may provide insight into the importance of membrane packing density as a design parameter for hemodialyzers and if changing the membrane packing density might provide equivalent performance at a lower dialysate flow rate.


Eligibility criteria:
inclusion criteria: * stable hemodialysis patients dialyzing through a native fistula or gore-tex graft. the access must be capable of delivering a stable blood flow of 400 ml/min. * age older than 18 years. * fluid removal requirement less than 3 liters per treatment. exclusion criteria: * noncompliance with dialysis regimen. * hematocrit less than 28%. * active infection

Keywords: hemodialysis dialysis, renal
amount of droplet formed during percutaneous dilatational tracheostomy

Conditions: Ventilatory Failure

Summary: during the percutaneous dilatational tracheostomy (pdt), large amount of droplets and aerosols are spread to the environment especially with the effect of ventilation during the dilatation phase. in such cases, it is recommended to take precautions such as masks and goggles or shields to protect practitioners from infection, however it has also been reported that droplets and aerosols can spread to the environment and can go far. flow controlled ventilation (fcv) with the use of tritube® and evone® could reduce droplet spread during pdt and provide a safer environment while operating on patients with infected airways.

during the percutaneous dilatational tracheostomy, large amount of droplets and aerosols are spread to the environment especially with the effect of ventilation during the dilatation phase. in such cases, it is recommended to take precautions such as masks and goggles or shields to protect practitioners from infection, however it has also been reported that droplets and aerosols can spread to the environment and can go far. flow controlled ventilation (fcv) with the use of tritube® and evone® could reduce droplet spread during pdt and provide a safer environment while operating on patients with infected airways. spss 21.0 (statistical package for the social sciences) (version 22.0, spss, inc, chicago, usa) program will be used for statistical analysis. after applying the shapiro-wilk test for normality, the student's t test will be used if the distribution is not normal. fisher's exact test or chi-square test will be used for categorical variables. results p\<0.05 will be considered significant. the investigators compared the amount of droplets scattered in the environment with pdt performed with fcv and conventional mechanical ventilation methods, with the atp (adenosine triphosphate) bioluminescence method.

Eligibility criteria:
inclusion criteria: * percutaneous tracheostomy procedure exclusion criteria: * whose written consent cannot be obtained * who undergo surgical tracheostomy for any reason * patients with active infection in the area of the procedure

Keywords: percutaneous dilatational tracheotomy flow controlled ventilation droplet
a clinical study of intismeran autogene (v940) plus pembrolizumab in people with high-risk melanoma (v940-001)

Conditions: Melanoma

Summary: the purpose of this study is to learn if intismeran autogene which is an individualized neoantigen therapy (int; formerly, called messenger ribonucleic acid \[mrna\]-4157) with pembrolizumab (mk-3475) is safe and prevents cancer from returning in people with high-risk melanoma. researchers want to know if intismeran autogene with pembrolizumab is better than receiving pembrolizumab alone at preventing the cancer from returning.


Eligibility criteria:
inclusion criteria: the main inclusion criteria include but are not limited to the following: * has surgically resected and histologically/pathologically confirmed diagnosis of stage iib or iic, iii, or iv cutaneous melanoma * has not received any prior systemic therapy for their melanoma beyond surgical resection * no more than 13 weeks have passed between final surgical resection that rendered the participant disease-free and the first dose of pembrolizumab * is disease free at the time of providing documented consent for the study * human immunodeficiency virus (hiv)-infected participants must have well controlled hiv on anti-retroviral therapy (art) exclusion criteria: the main exclusion criteria include but are not limited to the following: * has ocular or mucosal melanoma * has cancer that has spread to other parts of the body and cannot be removed with surgery * has heart failure within the past 6 months * has received prior cancer therapy or another cancer vaccine * has another known cancer that that has spread to other parts of the body or has required treatment within the past 3 years * has severe reaction to study medications or any of their substance used to prepare a drug * have not recovered from major surgery or have ongoing surgical complications
effect of trunk flexion on airway defense in parkinson's disease

Conditions: Parkinson Disease

Summary: the main mechanisms of airway protection include a properly functioning swallowing process and a cough. studies focusing on patients with parkinson's disease (pd) have previously demonstrated impairments in both swallowing (dysphagia) and coughing (dystussia). aspiration pneumonia is the leading cause of death in individuals with pd. swallowing function is directly related to body posture. postural abnormalities (pa) are a common symptom of pd and significantly contribute to patient disability, affect respiratory function, and reduce quality of life. previous research has shown that more than 20% of pd patients suffer from some form of pa. most pd patients with a forward trunk flexion angle greater than 30 degrees report specific difficulties, such as dysphagia. a link has previously been demonstrated between postural abnormalities associated with flexed posture and restrictive ventilatory impairment. it can be assumed that this restrictive ventilatory impairment, which reduces the amount of air the patient can inhale into the lungs and subsequently exhale, negatively affects the strength of voluntary cough. however, this hypothesis has not yet been verified in the mentioned patient group. the primary aim of the study will be to examine the effect of forward trunk flexion (ftf) in parkinson's disease on the airway defense system.

the primary aim of the study will be to verify the potential relationship between forward trunk flexion, respiratory muscle strength, and the strength of voluntary cough. hypotheses: 1. forward trunk flexion in patients with parkinson's disease (pd) will negatively affect respiratory muscle strength and the strength of voluntary cough. 2. respiratory muscle strength and the strength of voluntary cough will deteriorate more rapidly over a three-year period in patients with pd and forward trunk flexion than in patients with pd without forward trunk flexion. the secondary aim will be to correlate respiratory muscle strength and the strength of voluntary cough with handgrip strength and the pulmonary dysfunction index as potential screening methods. hypothesis: 1. handgrip strength and the pulmonary dysfunction index will correlate with respiratory muscle strength and the strength of voluntary cough.

Eligibility criteria:
inclusion criteria: * diagnosis of parkinson' s disease * age ≥ 18 years exclusion criteria: * unreliable performance of mip, mep, or grip strength measurements, for example, due to cognitive deficits (assessed by the researcher) * inadequate lip seal * significant deformities of the dominant hand that could affect the accuracy of grip strength measurements * other severe neurological diseases apart from pd * history of unstable cardiovascular disease * severe pulmonary disease

Keywords: parkinson disease postural abnormalities airway defense system
perception of quality of life in patients undergoing endoscopic vertical gastroplasty: a descriptive exploratory study

Conditions: Endoscopy; Quality of Life of Patients; ENDOSCOPIC VERTICAL GASTROPLASTY; Obesity

Summary: an emerging alternative to bariatric surgery for the treatment of obesity is bariatric endoscopic gastroplasty (gve), which offers a less invasive approach with fewer complications. however, the weight loss achieved through this technique is generally lower than that achieved with traditional bariatric surgery, leaving the impact on patients' quality of life uncertain. the aim of this multicentre exploratory descriptive study is to investigate the perception of the quality of life of patients with obesity undergoing gve, conducted at the complex operative unit of surgical digestive endoscopy of the university policlinico agostino gemelli irccs foundation as the promoting centre. italian patients over 18 years old, in post-gve follow-up for at least six months, with access to and familiarity with a computer or tablet will be included. data will be collected via a single semi-structured interview on microsoft teams, audio recorded and transcribed in full, and analysed using nvivo v1.6.2.32. participants' statements will be categorised into semantic categories and subsequently refined into sub-themes and themes through an iterative process.


Eligibility criteria:
inclusion criteria: * age: patients older than 18 years. * treatment: patients who have undergone gve surgery and have been in post- surgery for at least six months. * access and technological competence: patients who have a computer or tablet at home and are familiar with their use. * informed consent: patients who are able to understand and give informed consent informed consent to participate in the study. * language comprehension: patients who have a good understanding of the language italian language, both written and spoken, to ensure correct completion and understanding of the informed consent and the study instructions. exclusion criteria: * patients who have been enrolled in experimental studies involving additional procedures during gve will be excluded
efficacy, tolerability, and safety of nxn-462 in patients with post-herpetic neuralgia

Conditions: Post Herpetic Neuralgia

Summary: the purpose of this study is to investigate whether nxn-462, a selective nnos inhibitor, is effective in reducing pain levels in patients with post-herpetic neuralgia.

nxn-462 is designed to target the nitric oxide synthase system (nos), specifically the neuronal nos (nnos) isoform. by design, nxn-462 is a potent inhibitor of nnos with good affinity, and has little or no affinity for a range of g protein-coupled receptors, ion channels, and enzymes. nxn-462 is being developed as an oral therapy for the treatment of neuropathic pain syndromes, including phn. this drug design strategy provides a new therapeutic paradigm for the treatment of chronic neuropathic pain.

Eligibility criteria:
inclusion criteria: * male, or a non-pregnant, non-lactating female 18 years or older * have voluntarily provided written informed consent * able to speak, read, write, and understand english * clinical diagnosis of phn for a minimum of 6 months * pain intensity score of ≥3 on a 0-10 numerical rating scale (nrs) at the screening visit * generally in good health (other than phn) at screening exclusion criteria: * are pregnant and/or lactating * diagnosis of any chronic pain syndrome that would interfere with the assessment of phn * evidence of multiple causes of neuropathic pain,e.g.lumbar radiculopathy in the lumbosacral area * have had neuroablation or neurosurgical intervention for phn * have been taking opioid analgesics for \>5 days/week * have received nerve block or intrathecal analgesia within 6 weeks of the study * history of significant gastrointestinal disease, liver disease, renal disease, endocrine disease, or cardiovascular disease * clinically significant abnormal clinical laboratory test results or vital signs * are immunocompromised or immunosuppressed for any reason * history of alcohol or other substance abuse (not including nicotine or tobacco) within 5 years * significant psychiatric disorder which requires drug treatment (except depression or anxiety treated with selective serotonin re-uptake inhibitors) * have received an investigational drug or have used an investigational device within 30 days of screening. * have previously been randomized to this study

Keywords: shingles, neuropathic pain post herpetic neuralgia sleep
the evaluation of a full face mask seal for the treatment of obstructive sleep apnea

Conditions: Obstructive Sleep Apnea

Summary: the investigation is a prospective, randomized, single blinded, crossover study. the investigation is designed to evaluate the performance, comfort and ease of use of the f\&p trial full face mask seal amongst obstructive sleep apnea (osa) participants. a total number of 40-45 osa participants will be recruited for the trial by the investigation site

this study will involve three visits to the investigation site. during visit one participants will be randomized to, fitted with and issued with the first trial mask seal for use in- home for 7 ±4 days. the participants will then come in to return the mask seal and be fitted and issued with the second trial seal for use in home for 7±4 days. visit three will involve the participants returning the second trial seal and providing feedback.

Eligibility criteria:
inclusion criteria: * adult (22+ years of age) * able to give informed consent * apnea hypopnea index (ahi) ≥ 5 on diagnostic night * either prescribed automatic positive airway pressure (apap), continuous positive airway pressure (cpap) or bi-level positive airway pressure (pap) for osa * fluent in spoken and written english * existing f\&p full face mask user exclusion criteria: * inability to give informed consent * participant intolerant to pap * anatomical or physiological conditions making pap therapy inappropriate * current diagnosis of respiratory disease or carbon dioxide (co2) retention * pregnant or may think they are pregnant.