Kornimate/medical-research-clean huggingface dataset:
effect of estrogen therapy on objective sleep quality in postmenopausal women

Conditions: Insomniac Postmenopausal Women

Summary: 1. sex hormone including estrogen have synergistic effect to serotonin activity and decrease activity of monoamine oxidase activity so the norepinephrine is not be metabolized, these substance are important to regulate hemostasis and circadian process of sleep 2. estrogen also regulate gamma-aminobutyric acid (gaba) secretion * gaba substance is in order to initiate sleep and continue sleep 3. according to epidemiologic data, problem of sleep was increasing in postmenopause group compare to premenopause group (aged-match) 4. this research perform to find out the actual effect of estrogen in improving sleep quality.

1. 40-60 year-old postmenopausal women with insomnia and mild-moderate vasomotor symptom were screened and included in project 2. block of four randomization was use to categorize participants into 2 groups * study group (estrogen patch) * control group (placebo patch) 3. sleep quality was measured before intervention by subjective and objective sleep quality * subjective sleep quality (self sleep questionnaire) * objective sleep quality (wrist actigraphy and sleep diary): wrist actigraph sleep test at home for 1 week 4. intervention phase : continuous use of weekly patch for 8 weeks * estrogen patch in study group * placebo patch in control group 5. follow up phase * at 4 weeks of use, investigator will telephone call for follow up the participant's compliance and the side effects during patch use. * after completed use of 7th patch, sleep quality was measured again, self sleep quality questionnaire and 1 week-wrist actigraphy and sleep diary test 6. then the data will be analysed and open label, in nonhysterectomized postmenopausal women in study group will take the medroxyprogesterone acetate for washing out the endometrium for 2 weeks 7. the participants will be counseled, further investigate and proper treatment.

Eligibility criteria:
inclusion criteria: * postmenopausal women 40-60 years old * mild to moderate vasomotor symptom * insomnia * fluent read and write in thai language * inform consent exclusion criteria: * acute liver and gall bladder disease * undiagnosed abnormal bleeding per vagina * history of birads 3 from mammogram * history or current venous thrombosis, embolism * diagnosis of sleep disorder * use of hypnotic drug or antihistamine in the past month * diagnosis of psychiatric disorder such as depressive disorder, schizophrenia, anxiety disorder * no past history of malignancy * no history of chronic renal disease, alzheimer's disease, uncontrolled hypertension, uncontrolled diabetes mellitus * history of estrogen use in past 6 months * drug abuse, alcohol

Keywords: postmenopause sleep quality estrogen objective sleep quality actigraph
influence of medical clowning in videofluoroscopic examination of pediatric speech disorder

Conditions: Velopharyngeal Insufficiency

Summary: the purpose of this study is to determine whether a participation of a medical clown in videofluoroscopic examination of pediatric speech disorder such as velopharyngeal inadequacy, improves the collaboration of the pediatric patient, the patient's and the caregivers subjective experience, and the quality of the examination (shorter exposure to radiation, shorter time at the radiology suite, more accurate parameters retrieved from the imaging results).

velopharyngeal inadequacy (vpi) results in reduced speech intelligibility and nasopharyngeal regurgitation. vpi is more common in patients who previously underwent cleft palate repair, in craniofacial syndromes such as 22q11.2 deletion syndrome, or in neuromuscular diseases. part of the work-up sometimes includes videofluoroscopic examination of the palate's movement during speech. this procedure involves ionizing radiation and requires adequate collaboration by the examinee. the examination set-up is foreign to the child and can cause stres and anxiety which can hinder the examination's accuracy and completion. medical clowns professionalise in stress relieve. in this prospective controlled study, the study group will be accompanied by a medical clown from the arrival to the premise, through the actual examination and after exiting the exam room. the medical clown will explain about the upcoming examination and will induce a less stressed atmosphere. after the examination the clown will close the session for the patient. the control group will do the same procedure but without a medical clown. factors such as pulse, total time in the examination room, net time of exposure to radiation and quality of data will be collected for each patient. the patient (if 7 year old and up) and his caregivers will fill up after completion of the examination a short questionnaire about their experience. the data will be collected and summarized and then a statistical analysis will be made in order to compare the study group and the control group.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of velo-pharyngeal inadequacy exclusion criteria: * a patient or caregiver that did not consent to participate in the study

Keywords: velopharyngeal insufficiency fluoroscopy
second forward view examination of proximal colon on adenoma detection rate

Conditions: Colon Adenoma

Summary: this clinical trial is being conducted to assess whether second forward view examination of proximal colon could increase adenoma detection rate of right colon.


Eligibility criteria:
inclusion criteria: * all patients undergoing colonoscopy for screening in our hospital exclusion criteria: * previous history of resection of colon; * familial polyposis syndrome * inflammatory bowel disease * active antiplatelet or anticoagulant therapy prevent polypectomy; * pregnancy or lactating women
objective sleep disturbances in orthostatic intolerance

Conditions: Postural Tachycardia Syndrome; Chronic Orthostatic Intolerance

Summary: we wish to study sleep architecture in patients with chronic orthostatic intolerance. we will test the null hypothesis that there is no difference in time during the various phases of sleep between patients and healthy control subjects.


Eligibility criteria:
inclusion criteria: * diagnosed with chronic orthostatic intolerance (or healthy subject) exclusion criteria: * overt cause or acute orthostatic intolerance * pregnancy or lactation

Keywords: postural tachycardia syndrome sleep insomnia
dose ranging study to assess efficacy, safety, tolerability and pharmacokinetics of pf-06700841 topical cream in participants with mild or moderate atopic dermatitis

Conditions: Atopic Dermatitis

Summary: this study is being conducted to provide data on efficacy, safety, tolerability and pk of multiple topical formulation concentrations of pf-06700841 topical cream in the treatment of mild to moderate atopic dermatitis (ad). the study is intended to enable selection of the dose and dosing regimen (once daily \[qd\] vs twice daily \[bid\] application) for the future clinical development of topical pf-06700841.


Eligibility criteria:
inclusion criteria: * clinical diagnosis of atopic dermatitis for at least 3 months * investigator's global assessment (iga) score of 2 or 3 * eczema area severity index (easi) score of 3-21 * body surface area (bsa) of 2-20% * peak pruritus-numerical rating scale (ppnrs) of grade 2 or more exclusion criteria: * other forms of dermatological diseases (other than atopic dermatitis) * fitzpatrick skin type score greater than 5 * clinically significant abnormal ecg, vital signs, and laboratory values * infection with hbv, hcv, herpes zoster or tuberculosis

Keywords: mild-to-moderate atopic dermatitis topical
study of resistance strengthening versus ambulation post-liver transplant

Conditions: Liver Transplantation; Resistance Training; Activities of Daily Living

Summary: resistance strengthening exercise will increase strength and functional activity greater than ambulation in subjects post-liver transplantation.

individuals post liver transplantation are significantly muscle wasted due to chronic liver disease. current usual care only involves progressive ambulation. resistance exercise targeted at the lower extremities are anticipated to increase muscle strength in the muscles that extend the hip, extend the knee, and plantar flex the ankle more than seen with the usual care ambulation. the anticipated increases in strength should improve functional performance of activities such as standing from a chair, walking, and climbing stairs. the improvement in strength and functional performance should improve an individuals quality of life.

Eligibility criteria:
inclusion criteria: * undergone liver transplantation a minimum of 6 weeks and a maximum of 12 weeks prior to enrollment * ambulatory without physical assistance, but permitted to use a cane or walker exclusion criteria: * diagnosis of hepatocellular carcinoma * significant cardiopulmonary disease * neurological / neuromuscular disorder including cerebral vascular accident (cva), parkinson's disease, alzheimer's disease, dementia unrelated to hepatic encephalopathy, dystonia, multiple sclerosis, and polio. * blindness * inability to comprehend the english or spanish language

Keywords: muscle wasting strengthening liver disease transplant
high dose methotrexate with leucovorin rescue with or without glucarpidase in osteosarcoma

Conditions: Osteosarcoma

Summary: the purpose of this study is to demonstrate whether use of glucarpidase facilitates administration of the next cycle of chemotherapy as scheduled and improves safety and tolerability of hdmtx given with lv


Eligibility criteria:
inclusion criteria: * osteosarcoma * eligible to receive 2 sequential cycles of hdmtx-lv exclusion criteria: * prior administration of glucarpidase * progression of disease while on previous mtx treatment

Keywords: osteosarcoma high dose methotrexate leucovorin
effect of propofol on cardioprotective role of remote ischemic preconditioning (ripc)

Conditions: Myocardial Infarction

Summary: this study involves research using human subjects (cardiac surgical patients) to evaluate the effect of remote ischemic preconditioning (ripc) on cardioprotective outcomes. ripc applied to upper or lower extremities has been shown cardioprotective role by lowering release of cardiac troponin in patients with cardiac diseases. however, it is not clear whether anesthetics, such as propofol or sevoflurane, may impair the cardioprotective effect of ripc in cardiac surgical patients. therefore, the purpose of the study is to compare the effects of anesthetics on cardioprotection of ripc in patients undergoing cardiac surgery.

patients undergoing cardiac surgery using cardiopulmonary bypass will be randomized to control, propofol, or sevoflurane group. patients in the control group will receive remote ischemic preconditioning (ripc) on their upper arms before anesthetic induction. patients in the propofol or sevoflurane groups will receive ripc after anesthetic induction using propofol or sevoflurane, respectively. in all patients, arterial blood samples will be obtained before and after each ripc. from the samples, human dialysate will be obtained and perfused to rat heart through langendorff apparatus before ischemia-reperfusion injury to the rat heart. infarct size of the sectioned rat heart will be compared among the three - control, propofol, and sevoflurane - groups.

Eligibility criteria:
inclusion criteria: * asa class i\~iii patients undergoing cardiac surgery using cardiopulmonary bypass exclusion criteria: * cardiac surgery without using cardiopulmonary bypass * descending thoracic aortic surgery * strenuous exercise, excessive alcohol or caffeine intake 24 hours before remote ischemic preconditioning * left ventricular ejection fraction \< 30% * uncontrolled hypertension or diabetes mellitus * severe renal or hepatic dysfunction * patients on hemodialysis * patients with arterio-venous fistula on arms or any reason to protect arms * peripheral vascular or nerve disease, bleeding tendency * preoperative use of iabp, ecmo, or ventricular assist devices * emergency operation, redo operation * refuse to enroll * pregnancy * preoperative use of beta-blockers

Keywords: propofol sevoflurane preconditioning
diagnosis of acute obstructive renal failure by clinical ultrasound performed by the emergency physician.

Conditions: Acute Kidney Failure

Summary: acute renal failure is frequently diagnosed in the emergency room during a biological assessment. its discovery requires determining the cause, which may be either functional, or obstructive. the obstructive cause is responsible for 10% of acute renal failure. it is recommended to start the exploration of this pathology with an ultrasound in search of an obstructive cause. however, ultrasound from the radiologist is not always available. the realization of this ultrasound by the emergency physician would reduce the time to obtain the diagnosis and therefore the time of passage to the emergency room. no study has yet been carried out to validate the performance of this ultrasound by the emergency physician in the case of acute renal failure. this study would validate the diagnostic performance of this ultrasound technique in order to identify as quickly as possible patients with acute renal failure whose cause is obstructive.

acute renal failure is frequently diagnosed in the emergency room during a biological assessment. its discovery requires determining the cause, which may be either functional, i.e. kidney dysfunction, or obstructive. the obstructive cause is responsible for 10% of acute renal failure. it is recommended to start the exploration of this pathology with an ultrasound in search of an obstructive cause. however, ultrasound from the radiologist is not always available. the realization of this ultrasound by the emergency physician would reduce the time to obtain the diagnosis and therefore the time of passage to the emergency room. no study has yet been carried out to validate the performance of this ultrasound by the emergency physician in the case of acute renal failure. the aim of this research is to evaluate the performance of clinical ultrasound in the diagnosis of an obstructive cause of acute renal failure by the emergency physician.

Eligibility criteria:
inclusion criteria: * patients admitted to an emergency structure * patients with acute renal failure (defined by an increase of 1.5 x the baseline serum creatinine value (known or expected according to age and sex)) exclusion criteria: * patients unable to express their non-objection * patients who have undergone a kidney transplant * dialysis patients * pregnant women

Keywords: acute renal failure ultrasound diagnosis
tranexamic acid in radical resection and endoprosthetic reconstruction

Conditions: Musculoskeletal Cancer; Sarcoma,Soft Tissue

Summary: this study intends to determine if any correlation exists between administration of txa or not to musculoskeletal oncology patients undergoing endoprosthetic reconstruction and blood loss and blood transfusion rates.

resection of bony and soft tissue tumors with endoprosthetic reconstruction often presents a significant risk of perioperative blood loss requiring transfusion. tranexamic acid (txa) is an antifibrinolytic that is commonly used to reduce blood loss in orthopedic procedures, most often arthroplasty. the aim of this study is to determine in a randomized controlled fashion if there is any difference in perioperative blood loss and blood transfusion rates when txa is used compared to when it is not used in patients undergoing radical resection of bone and soft tissue sarcomas with endoprosthetic reconstruction.

Eligibility criteria:
inclusion criteria: * patients undergoing wide resection of a malignant bony tumor of the lower extremity with endoprosthetic reconstruction. * patients undergoing a resection of soft tissue sarcoma measuring \> 5cm. exclusion criteria: * patients undergoing revision endoprosthetic reconstruction * patients with known coagulopathy * known history of dvt or embolic disease * benign tumors * patients with allergy to txa * those refusing blood products * those concurrently on anti-coagulant therapy * pregnant and/or nursing women * vulnerable populations as defined by the kumc irb
anchor for robotic sacrocolpopexy

Conditions: Pelvic Organ Prolapse

Summary: 1. primary objective: to assess the effect of absorbable anchor compared to suturing for mesh attachment to vagina in robotic assisted sacrocolpopexy on the length of surgery for this portion of the procedure. 2. secondary objectives: i. to assess intraoperative and ii. postoperative complication rates, iii. intraoperative 10 cm visual analog scale (vas), to subjectively assess surgeon satisfaction with the technique iv. post-operative pelvic organ prolapse quantification (popq) evaluation for anatomic failure and v. a vas of the vaginal walls overall appearance

by applying a commonly used surgical technique of absorbable anchors to a new surgery, sacrocolpopexy (scp), operative time may be decreased while providing similar patient outcomes. absorbable anchors have been validated in mesh fixation during laparoscopic surgical repair of hernias. this technique potentially takes less time than traditional suturing, thus decreasing cost and morbidity of anesthesia. the investigators hypothesis proposes that for women undergoing scp at a large managed care organization, participants receiving anchor suture staples to attach the mesh to the vagina compared to participants receiving standard treatment will require 50% shorter surgical time for the mesh attachment portion of the surgery. the investigators secondary hypothesis is for women undergoing scp at a large managed care organization, participants receiving anchor suture staples to attach the mesh to the vagina compared to participants receiving standard treatment will have similar rates of intra-operative and post-operative complications and surgical failure. on vas, patients will not have different appearance of the vaginal walls. surgeons will report higher satisfaction with the anchor technique.

Eligibility criteria:
inclusion criteria: * age 21 or older * diagnosis of pop, defined as the descent of one or more of four different anatomic structures, a)the uterus(cervix), b)the apex of the vagina (in those status post hysterectomy) c) the anterior vaginal wall, or d) the posterior vaginal wall. this is defined on exam as the popq points ba, c, or bp \>0 cm beyond the hymen, uterine(cervix) descent into at least the lower half the vagina (defined as point c\> -tvl/2) or post hysterectomy vault into the lower 2/3 of the vagina. bothersome bulge symptoms as indicated on question 3 of the pelvic floor disorder inventory (pfdi-20) form relating to 'sensation of bulging' or something 'falling out' * desire surgical treatment for pop with scp * available for up to 6 months of follow up * not pregnant or desiring future pregnancy * written informed consent is obtained. exclusion criteria: * known adverse reaction to synthetic mesh, or complications including but not limited to erosion, fistula, or abscess. * cervical intraepithelial neoplasia (cervical intraepithelial neoplasia (cin) 2, cin3, or cancer) * unresolved chronic pelvic pain * prior abdominal or pelvic radiation * contraindications to the surgical procedures including known horseshoe kidney, pelvic abscess or active diverticular abscess or diverticulitis
dexmedetomidine use in infants undergoing cooling due to neonatal encephalopathy (dice trial)

Conditions: Hypoxic-Ischemic Encephalopathy; Pain

Summary: management of neonatal pain and sedation often includes opioid therapy. a growing body of evidence suggests long-term harm associated with neonatal opioid exposure. providing optimal sedation while neonates are undergoing therapeutic hypothermia (th) may be beneficial but also presents therapeutic challenges. while there is evidence from animal models of brain injury and clinical trials in adults to support the safety and neuroprotective properties of dexmedetomidine (dmt), there are no published large clinical trials demonstrating safety and efficacy of dmt use in neonates with hypoxic-ischemic encephalopathy (hie) during treatment with th. this study is innovative in proposing a phase ii, 2-arm trial providing the opportunity to evaluate the use of dmt as compared to the use of morphine for sedation and pain management for babies undergoing th. we propose to confirm optimal dmt dosing by collecting opportunistic pharmacokinetics (pk) data and determine safety of dmt in this population. these data will inform a larger phase iii efficacy trial.


Eligibility criteria:
inclusion criteria: * neonates ≥36 weeks' gestational age diagnosed with moderate-to-severe neonatal encephalopathy and treated with th (target temperature 33.5°c) for a planned duration of 72 h. * infants requiring sedation and/or treatment to prevent shivering during th as assessed by the neonatal pain, agitation, and sedation scale (n-pass) scores and a modified bedside shivering assessment scale. * informed consent document approved by the institutional review board (irb) obtained prior to randomization exclusion criteria: * known chromosomal anomalies * cyanotic congenital heart defects * redirection of care being considered because of moribund condition, or a decision made to withhold full support

Keywords: therapeutic hypothermia dexmedetomidine