Kornimate/medical-research-clean huggingface dataset:
visualization of cerebral arteries using contrast-enhanced transcranial ultrasound in stroke patients

Conditions: Stroke

Summary: the purpose of this study is to find out more about the usefulness of ultrasound in combination with a contrast solution to look for blood vessel blockage or occlusion in the brains of stroke patients.

ischemic stroke is a common, devastating and costly disease. a stroke is usually caused by a blockage in one of the arteries that carries blood to the brain. the purpose of this study is to visualize the blood vessels in the brain and to look for vessel occlusion (i.e., blockage) which may be the cause of stroke. ultrasound contrast imaging may or may not improve the ability to diagnose vessel occlusion in the brain quickly and precisely, thereby expediting the therapy currently in place for acute stroke. the contrast solutions used in this study have been approved by the food and drug administration because they improve ultrasound pictures taken in the heart. while the solutions are approved for use with ultrasound in viewing the heart, the usefulness in viewing brain vessels has not been approved and is experimental. the study will enroll 400 participants with possible diagnosis of acute stroke. individuals participating in the study will be injected with a contrast solution via an intravenous line. a small probe will be used to obtain images of blood vessels in the head. the study researchers will measure vital signs prior to injection of the contrast solution, 5 minutes after the injection, and at the end of the ultrasound. each participant will have a 5-minute mental function assessment and a brief neurological exam. participants will undergo at least 3 ultrasounds. the total time of each ultrasound is less than 30 minutes. this study is part of the specialized program of translational research in acute stroke to enhance and initiate translational research that ultimately will benefit stroke patients. results from this study may help investigators learn about the future development of new diagnostic tests for stroke.

Eligibility criteria:
inclusion criteria: * patient 18 years of age or older * code stroke patient exclusion criteria: * women with positive pregnancy test * women who are breast feeding * severe emphysema * pulmonary vasculitis * history of pulmonary emboli * chronic renal failure

Keywords: stroke ultrasound occlusion blockage contrast solution
the sleep in pregnancy study

Conditions: Pregnancy Related; Sleep Disordered Breathing; Obesity

Summary: sleep disordered breathing (sdb) insidiously worsens metabolic function, heightens insulin resistance (ir), and in pregnancy is thought to precipitate gestational diabetes, preterm birth, growth restriction, gestational hypertension, and preeclampsia. despite the fact that sleep disturbances are common during pregnancy, sdb remains under-recognized, under-diagnosed, and poorly understood, particularly in pregnancies affected by obesity. sixty percent of pregnancies are now affected by obesity, yet the relationship between sdb, patterns of glycemia, and insulin resistance (ir) in obese pregnant women is a neglected area with major therapeutic implications to improve maternal and infant health. using a prospective design in which diet and gestational age are highly controlled, the investigators propose to measure sdb (apneas/hypopneas) in obese pregnant women using an ambulatory sleep monitoring system. in parallel, robust patterns of glycemia will be measured with a continuous glucose monitoring system (cgms), followed by a 75g oral glucose tolerance test to measure insulin action. the investigators global hypothesis is that worse sdb in part accounts for higher 24-hour patterns of glycemia in obese normal glucose tolerant (ngt) pregnant women in their 3rd trimester. the investigators will test the hypothesis that: 1) in obese ngt pregnant women at 32-34 weeks gestation on a controlled eucaloric diet, higher apnea hypopnea index (ahi) will be positively associated with 24-hour glycemia measured by a cgms and that, 2) higher ahi in obese ngt pregnant women at 32-34 weeks gestation on a eucaloric controlled diet will be associated with higher insulin resistance measured by a 75g oral glucose tolerance test (matsuda model). early identification and treatment has the potential to decrease long-term maternal cardiovascular morbidity and mortality.


Eligibility criteria:
inclusion criteria: * pregnant women: 1. between the ages of 20-39 yrs, 2. at 32-34 weeks gestation, 3. who have a bmi of ≥30 to ≤40 kg/m2, 4. who have a singleton pregnancy, and 5. who have a normal glucose tolerance test on entrance to the study. exclusion criteria: * pregnant women: 1. who have a diagnosis of diabetes (gdm, type 1 or type 2), 2. who are using beta blockers/glucocorticoids. 3. who have other children who are ≤2 yrs old (due to risk of disrupted sleep), 4. with diagnosed sleep disorders (e.g. osa, insomnia, restless leg syndrome), 5. who work night or rotating shifts, 6. who report use of sleep medications will be excluded, 7. with diagnosed pulmonary or cardiovascular disease 8. who do not speak english.
additional 4 cycles of cisplatin (cddp4) in patients with triple negative breast cancer for neoadjuvant chemotherapy

Conditions: Breast Cancer

Summary: achievement of pathologic complete response is important prognosticator to predict long term outcome in triple negative cancer. the efficacy of adding 4 cycles of cisplatin (cddp4) is to be investigated whether addtional pathologic complete response is achieved for those triple negative breast cancer patients who recieved 4 cycles of adriamycin with cyclophosphamide(ac4) but did not reach clinical complete response during the course of neoadjuvant therapy.

first outcome measures (analysis) :at the time of surgery, second outcome measures: 2019 august, 5 year overall survival, disease free survival

Eligibility criteria:
inclusion criteria: 1. patients with histologically proven breast cancer 2. age, at least 20 years 3. er/pr/her2 (negative/negative/negative * er/pr negative: nuclear reaction \< 1%, allred score 0 or 2 * her2 negative: her2; ihc (immunohistochemistry) 0,1+ or fish/sish (-) in case of ihc 2+ 4. clinically stage ii or iii with histologically proven lymph-node involvement (t \>1.5 cm or lymph node \[ln\] \>1.5 cm) 5. eastern cooperative oncology group (ecog) performance status 0 or 1 6. no prior hormonal treatment, chemotherapy or radiotherapy is allowed. 7. adequate hematologic, liver and kidney function 8. written informed consent exclusion criteria: 1. pregnancy or lactation 2. prior chemotherapy or radiotherapy for any malignancy 3. stage t4d; inflammatory breast cancer 4. no primary tumor (t0) 5. documented history of cardiac disease contraindicating anthracyclines 6. currently active infection
part b: efficacy and safety of aevi-001 in children and adolescents with adhd and without mglur mutations

Conditions: Attention Deficit Hyperactivity Disorder

Summary: this is part b of a 2-part, 6-week, double-blind, dose-optimization, parallel-group study in children and adolescents (ages 6-17 years) with adhd with and without cnvs in specific genes implicated in glutamatergic signaling and neuronal activity. part b will assess subjects who do not have cnvs in any of the specific gene mutation(s) implicated in glutamatergic signaling and neuronal connectivity.


Eligibility criteria:
inclusion criteria: 1. subject and parent/legally authorized representative (lar) can speak english fluently and have provided written informed consent, and assent (as applicable) for this study. 2. subject is 6 to 17 years of age (inclusive) at the time of consent/assent. the date of signature of the informed consent/assent is defined as the beginning of the screening period. this inclusion criterion will only be assessed at the screening visit (visit 1). 3. subject is male or non-pregnant, non-lactating female, who if of childbearing potential agrees to comply with any applicable contraceptive requirements prior to administration of investigational product (ip). 4. subject meets diagnostic and statistical manual of mental disorders, fifth edition (dsm-5) criteria for a primary diagnosis of adhd based upon dsm 5 criteria. 5. subject has a minimum score of ≥28 on the adhd-rs-5 at the baseline visit (visit 2). 6. subject has been genotyped previously and has their identity confirmed (if required). exclusion criteria: 1. subject or parent/lar is, in the opinion of the investigator, mentally or legally incapacitated, has significant emotional problems at the time of the screening visit (visit 1) which could interfere with the conduct of study evaluations. 2. subject has a current, controlled or uncontrolled, co-morbid major psychiatric diagnosis (aside from adhd), including an anxiety disorder, major depression, bipolar disease, schizophrenia (or any psychotic disorder), and moderate or severe intellectual disability. mild anxiety and/or depressive symptoms that do not meet diagnostic criteria for an anxiety disorder or major depression and/or do not require treatment are not exclusionary. 3. subject has autism spectrum disorder to include a dsm-iv diagnosis of autistic disorder, asperger's disorder, or pervasive developmental disorder. 4. subject is currently taking any medication that might confound the results of safety assessments conducted in the study. 5. subject has a known history of cardiovascular disease, advanced arteriosclerosis, structural cardiac abnormality, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, cardiac conduction problems, exercise-related cardiac events including syncope and pre-syncope, or other serious cardiac problems. 6. subject has any clinically significant abnormality on 12-lead ecg performed at the screening visit (visit 1) and/or the baseline visit (visit 2) such as serious arrhythmia, cardiac conduction problems, or other abnormalities deemed to be a potential safety issue.
prevalence of acute injuries in amateur and elite mountain bikers

Conditions: Acute Injury in Mountain Biking

Summary: the investigators intented to assess the prevalence of acute injuries in amateur and elite mountain bikers.

in order to assess the prevalence of acute injuries in amateur and elite mountain bikers a questionnaire was created in accordance to existing literature. the questionnaire was translated in several languages by bilingual people familiar with mountain biking. the questionnaire focussed on demographic data, training volume, number of races per year, number of injuries since practising mountain biking, wearing of protective gear items and accident mechanism. the survey was conducted during the swiss epic mountain bike event in 2017. all riders were asked to voluntarily participate in the survey.

Eligibility criteria:
inclusion criteria: * mountain bikers participating in the swiss epic mountain bike event in 2017 exclusion criteria: * non-participators, non-mountain bikers in the swiss epic mountain bike event in 2017
imaging of active granulomas with [18f]fdg and selected inflammatory pet tracers in pulmonary sarcoidosis

Conditions: Pulmonary Sarcoidosis

Summary: the goal of the current study is to evaluate the potential of the selected pet tracers to detect sarcoidotic lesions in lungs. the tracers are already in clinical use for the detection of certain inflammatory processes or malignant tumors, and their targets present similarities with molecular mechanisms of sarcoidosis.

the diagnosis of sarcoidosis is difficult since there is no specific noninvasive method available to diagnose sarcoidosis. fdg-pet imaging is in use, however, fdg is not a specific tracer for sarcoidosis and other inflammatory diseases may interfere with the imaging findings. the aim of the current protocol is to evaluate the potential of other inflammatory pet-tracers in the detection of sarcoidotic lesions. the patients with active sarcoidotic lesions in lungs will be recruited. first, the patient undergoes pet-fdg scan and then the patient undergoes the pet scan either with c11-methionine or 68ga-dotanoc. the results with the latter tracers will be compared to the imaging results with fdg.

Eligibility criteria:
inclusion criteria: * patient with sarcoidosis exclusion criteria: * any malignant disease * any significant other inflammatory or infectious disease affecting lungs * pregnancy
virtual reality intervention procedure simulator

Conditions: Novice Doctor

Summary: the purpose of this study is to prove the effectiveness of the virtual reality program in educating lumbar transforaminal epidural blocks to novice doctors.


Eligibility criteria:
inclusion criteria: * residents in department of anesthesiology and pain medicine unfamiliar with fluoroscopy guided epidural block exclusion criteria: * residents in department of anesthesiology and pain medicine familiar with fluoroscopy guided epidural block
nitroglycerin infusion during cardiac surgery

Conditions: Lactic Acidosis; Blood Glucose, High

Summary: hypothermic cardiopulmonary bypass results in peripheral vasoconstriction and heparin trapping. hypoperfusion and ischemic-reperfusion injury are associated with systemic inflammatory response, while insufficient and delayed neutralization of heparin by protamine may contribute to more blood loss during rewarming stage. nitroglycerin infusion, an no-related vasodilator, is an established and effective treatment for unstable angina, myocardial infarction, congestive heart failure, and perioperative hemodynamic management for cardiac surgery. therefore, we hypothesize that nitroglycerin infusion during rewarming corrects systemic ischemic stress and facilitates heparin neutralization in cardiac surgery.

a randomized clinical trial in a tertiary academic center in patients with cardiac surgery, to receive either nitroglycerin infusion dose of 0-0.1 mcg/kg/min, or 1-5 mcg/kg/min during rewarming in cardiopulmonary bypass.

Eligibility criteria:
inclusion criteria: * elective cardiac surgery exclusion criteria: * heart failure, respiratory failure, asthma attack, uremia, normothermic bypass.

Keywords: nitroglycerin cardiopulmonary bypass cardiac surgery
ketamine for pain, opioid use, and mental health in orthopedic trauma patients

Conditions: Orthopedic Trauma Surgery Patients; Postoperative Pain; Opioid Use; Depression; Post-traumatic Stress Disorder (PTSD)

Summary: the goal of this clinical trial is to learn whether a single dose of ketamine during surgery can help lower pain, reduce the need for opioid medications, and improve mental health recovery in adults with serious orthopedic injuries. the main questions it aims to answer are: does ketamine lower pain after surgery? does ketamine help reduce how much opioid medicine participants need? does ketamine improve symptoms of depression and post-traumatic stress disorder (ptsd)? researchers will compare participants who receive ketamine during surgery to those who receive standard anesthesia without ketamine. participants will: receive either ketamine or standard anesthesia during surgery answer survey questions about pain, depression, and ptsd at several points after surgery (from a few days up to 6 months) be followed by the research team through clinic visits and phone calls

this randomized controlled trial will evaluate whether giving a single dose of intravenous (iv) ketamine during surgery can improve postoperative outcomes for adults with severe orthopedic injuries. participants will be adults aged 18-65 undergoing surgery for musculoskeletal trauma at a level i trauma center. all eligible participants will have an injury severity score (iss) greater than 15. participants will be randomly assigned to receive either standard general anesthesia or anesthesia with an added dose of iv ketamine (0.5 mg/kg). the study will track pain levels, opioid use, and symptoms of depression and post-traumatic stress disorder (ptsd) using validated surveys and pain rating scales. outcomes will be measured at multiple points after surgery, including 1-7 days, 2-3 weeks, 3 months, and 6 months. this study will help determine if ketamine can improve both physical and mental recovery in people with complex orthopedic trauma, and whether it should be considered as part of routine trauma care.

Eligibility criteria:
inclusion criteria: * adults aged 18-65 * undergoing acute operative fixation for musculoskeletal trauma * injury severity score (iss) greater than 15 * ability to provide informed consent (or consent provided by a legally authorized representative) exclusion criteria: * age under 18 or over 65 * use of ketamine for preoperative or postoperative sedation * known allergy or contraindication to ketamine * prior unsuccessful ketamine therapy for major depressive disorder (mdd) or ptsd * severe psychiatric conditions or psychotic features * history of dementia or glaucoma * currently engaged in trauma-focused cognitive behavioral therapy or ptsd psychotherapy started within the past 3 months

Keywords: ketamine orthopedic trauma postoperative pain opioid reduction depression ptsd musculoskeletal injury trauma surgery
antibiotic use in distal hypospadias repair

Conditions: Hypospadias

Summary: hypospadias is a common condition where the opening of the penis is not located at the tip, but along the underside of the penis. it is estimated to occur in 1/300 live male births, making it one of the most common birth defects. degrees of hypospadias ranged from minor to severe depending on the location of the opening. surgical repair is often required and involves placement of a catheter for the urine to drain with known urinary colonization found on prior retrospective studies. the current practice of using preventative antibiotics as long as the catheter is in place is conflicting with resent studies that show antibiotics may not be necessary to prevent urinary tract infections (utis). the purpose of this study was to see how common symptomatic utis were after hypospadias repair surgery; and to see whether routine antibiotic use after surgery affected the rate of utis. subjects were randomized to either receive antibiotics or no antibiotics after distal hypospadias repair. the research coordinator made follow-up phone calls with the family and the primary care provider (pcp) after stent removal, 30 days post surgery and after the 3 month post surgical visit.

males undergoing distal hypospadias repair involving stent placement were randomized to either receive or not to receive antibiotics post-operative. all subjects did not receive intra-operative antibiotics. routine follow-up included having the stent removed one week post-op and a return visit at 3 months. the research nurse made follow-up phone calls to the family or the (pcp) one week after the stent was removed and at one month post-op to see how things were going with the child and again after teh 3 month post surgical visit, if the subject did not return after multiple rescheduling attempts.

Eligibility criteria:
inclusion criteria: * males undergoing primary distal hypospadias repair with open urethral stent drainage. exclusion criteria: * males undergoing fistula repair or glandular hypospadias repair without incontinent urethral stent drainage and hypospadias repair of mid or more proximal degrees of hypospadias were excluded from this study.

Keywords: distal hypospadias repair urinary tract infection prophylactic antibiotic use
tranexamic acid and ethamsylate for preventing pph in patient undergoing lscs at high risk for pph

Conditions: Postpartum Hemorrhage

Summary: the aim of this study is to compare the effect of low dose of tranexamic acid (1gm) and ethamsylate (1gm) after prophylactic oxytocin administration versus placebo with prophylactic oxytocin given in the 2 minutes after child delivery in patient undergoing lscs at high risk for post partum hemorrhage

research question: is the combination of tranexamic acid and ethamsylate is more effective than oxytocin alone for preventing postpartum hemorrhage if they are given after delivery of the fetus ?

Eligibility criteria:
inclusion criteria: 1. women undergoing elective caesarean section 2. patient having one or more risk factor for pph * multiple pregnancy * polyhydramnios (afi \>25cm) * macrocosmic baby (\>4.5 kg) * prolonged , augmented and obstructed labour * obese patients(bmi \>30) * premature rapture of membranes * previous history of pph 3. age ≥18 years 4. gestational age ≥ 35 weeks 5. informed oral consent from the patient exclusion criteria: 1. history of venous thrombosis (dvt and/or pulmonary embolism) or arterial thrombosis (angina pectoris , myocardial infarction, stroke) 2. history of epilepsy or seizure 3. any known cardiovascular , renal or liver disease 4. autoimmune diseases 5. sickle cell disease 6. severe hemorrhagic disease 7. placenta previa. 8. morbidly adherent placenta 9. abruptio placenta 10. eclampsia, hemolysis, elevated liver enzymes, and low platelet count syndrome 11. administration of low molecular weight heparin or anti platelets the week before delivery .
comparison of safety and efficiency of 20w 30w holmium laser device in treatment of 1-2 cm diameter kidney stones with rirs

Conditions: Nephrolithiasis

Summary: to compare the safety and efficiency of 20w 30w holmium laser device in treatment of 1-2 cm diameter kidney stones with retrograde intrarenal surgery (rirs).


Eligibility criteria:
inclusion criteria: * patients who are between 18-90 years old * patients undergoing rirs for treatment of 1-2 cm diameter kidney stones exclusion criteria: * patients who have congenital urogenital abnormalities * patients who have previous stone surgery history

Keywords: rirs, holmium, 1-2 cm,stones,kidney