Kornimate/medical-research-clean huggingface dataset:
liver protection of ripc in pediatric living donor liver transplantation

Conditions: Hepatic Ischemic and Reperfusion Injury

Summary: remote ischemic preconditioning(ripc) is emerging as an promising therapeutic paradigm to combat the detrimental impact of ischemic and reperfusion injury. in liver transplantation, ischemic and reperfusion injury severely impacts the post-surgery liver function and patient outcome. this prospective, double blind, randomized clinical trial is aimed to test the protective effect of ripc against hepatic ischemic and reperfusion injury in pediatric liver transplantation.

pediatric liver transplantation remains the major therapeutic strategy for pediatric biliary atresia patients. with almost 60 years of improvements and refinements in surgical techniques and perioperative management standards, liver transplantation is gaining popularity and gradually turns out to be the only curative treatment option for patients with irrevocable liver failure, such as childhood acute or chronic liver failure, inherited liver diseases and also biliary atresia. in liver transplantation, hepatic ischemic and reperfusion injury (hiri) remains to be a critical clinical issue. importantly, it is well known that the severity of hiri may have fundamental impact on the transplanted organ function and long term graft survival. furthermore, pediatric patients are more venerable and less tolerated to receive an ischemic donor liver due to their small body weight.although detrimental impact of hipi on graft function has long been recognized, little progress has been made to attenuate the severity of the hipi compared to cardiac ischemic and reperfusion (ir) injury. in experimental animal models, remote ischemic preconditioning has been consistently shown to have beneficial effects. however, this protective paradigm has yet not been tested in liver transplantation patients in clinical scenario. considering the growing number of pediatric patients undergoing liver transplantation and their possibly underdeveloped organ function, the investigators sought to determine whether remote ischemic preconditioning could ameliorate hipi and improve long term graft/patient survival in pediatric liver transplantation patients using this double-blind randomized clinical trial.

Eligibility criteria:
the inclusion criteria were as follows: 1. american society of anesthesiologists score of i-iii; 2. age of 3-72 months 3. elective living lt surgery. the exclusion criteria were as follows: 1. peripheral vascular disease; 2. history of thromboembolism; 3. systemic or local infection before surgery; 4. autoimmune diseases; 5. severe congenital heart disease 6. history of lt.

Keywords: ripc hepatic ischemic and reperfusion injury pediatric living donor liver transplantation
cast immobilization versus functional therapy for acute, severe lateral ankle sprains

Conditions: Ankle Sprain

Summary: acute, severe lateral ankle sprains are estimated to comprise between 3-5% of emergency department visits and are the most common musculoskeletal injury in the physically active population. although the current accepted treatment of ankle sprains is to encourage early mobilization with functional rehabilitation, there is little high-quality evidence directing this clinical practice. this pilot study is to: * provide quantitative data for estimation of mean outcome scores and standard deviations to allow subsequent sample size calculations * evaluate the feasibility of the proposed study design * assess patient enrollment issues specific to randomization into an active rehabilitation program compared to below knee immobilization.


Eligibility criteria:
inclusion criteria: * age over 18 * meet clinical criteria for unilateral grade ii-iii ankle sprains (inability to weight bear) exclusion criteria: * bony injury on x-ray or computed tomography * contraindications to recurrent icing * high risk of deep-vein thrombosis * injury greater than 3 days old * ongoing recovery from previous acute ankle sprain * age greater than 60 * non-english speaking patients, those patients unable to provide informed consent or patients with insufficient contact information for follow-up

Keywords: ankle sprain functional rehabilitation immobilization
enteral feeding study of formula containing fish oil in critical care setting

Conditions: Trauma; Tube Feeding

Summary: the purpose of this study is to evaluate the clinical applicability of an enteral tube feeding formula containing fish oil and prebiotics in a critical care population.

in terms of nutrition support in the acute care setting, it is generally accepted that 1. earlier is better 2. enteral is superior to parenteral 3. the quality of nutrients appears more important than quantity 4. select populations will show additional benefit from specific nutrient supplementation. the current study is designed to evaluate the tolerance of an enteral formula in trauma and surgery patients, as demonstrated by achieving and maintaining enteral feeding goal, gastrointestinal tolerance and inflammatory markers.

Eligibility criteria:
inclusion criteria: * 18 - 70 years old * new icu admit * enteral tube feeding anticipated for at least 7 days * informed consent exclusion criteria: * enteral tube feeding immediately prior to admit * parenteral feeding * medical condition that preclude receiving tube feeding or formula * determined by pi to be inappropriate * participating in another clinical trial

Keywords: enteral feeding critical care fish oil surgical
subglottic secretion culture in predicting tracheal microbial flora

Conditions: Pneumonia

Summary: ventilator-associated pneumonia (vap) continues to be a major cause of morbidity and mortality in the intensive care unit (icu). microaspiration of subglottic secretions accumulated above the endotracheal tube cuff is the primary route of bacterial entry into the lower respiratory tract.therefore, removal of secretions from the subglottic spacehas been recommended as a preventive strategy to avoid microaspiration and vap. in this context, whereas considerable literature exists on the use subglottic secretion drainage (ssd) in patients at risk for developing vap, there is a lack of data on the bacterial growth in the subglottic fluid above the cuff. the primary objective of the study will be to assess the value of subglottic secretion culture in predicting microbial flora of endotracheal aspirate samplein patients admitted to our icu and under invasive mechanical ventilation for at least 48 hours. secondary end-point will be to estimate the predictive value of subglottic secretion culture in identifying bacterial pathogens in the sub-population of patients who will develop vap.


Eligibility criteria:
inclusion criteria: * ≥18 years of age * invasive mechanical ventilation for at least 48 hours exclusion criteria: * age \<18 years * absence of informed consent * pregnancy * documented treatment-limitation orders in the patient's chart
effect of pulsing electrical fields on lower extremity diabetic neuropathy: a pilot, open-label study

Conditions: Diabetic Peripheral Neuropathy

Summary: to determine if pulsed electric field therapy reduces lower leg and foot pain associated with diabetic neuropathy and lessens the need for medication. the medrelief device sends a sub-threshold electric signal through the skin using electrodes as means of signal delivery. the signal or waveform, frequency and strength were created to match the characteristics of signals the body generates to help natural healing.

a multi-center, randomized, open-label study involving 23 patients with chronic diabetic peripheral neuropathy meeting study entry criteria. subjects will be randomly assigned to receive one of two treatments using an fda cleared medrelief device: (1) a medrelief se 55 device set on "pulsed" mode at 10 microsecond burst intervals 4150 ha, or (2) a medrelief se 55 device set on "continuous" mode at 4150 hz. subjects will wear the device on target foot each night for a minimum of 6 hours over a two week (15 day treatment)period. subjects will complete a daily pain diary, medication form, and device use form. subject global assessments and physician global assessments will occur at baseline, study visits day 7, day 15 and day 21 (end of study). response to therapy will include pain reduction, improvement in sensation, improved response to vibratory stimulation and reduction of edema in study subjects.

Eligibility criteria:
inclusion criteria: * currently diagnosed with diabetes mellitus * confirmed diagnosis of diabetic peripheral neuropathy * age 18 years to 75 years * both males and females are eligible for study participation * hga1c level under 9 * physician confirmed stable glycemic control for 3 months prior to enrollment * baseline pain level over previous month of 5 * willing to sign irb approved consent and follow study visit requirements * if female of childbearing age willing to undergo urine pregnancy test exclusion criteria: -

Keywords: diabetes mellitus neuropathy distal symmetric polyneuropathy pulsed electric fild
effect of music listening on stress in acute stroke

Conditions: Acute Stroke

Summary: investigation on changes in the neurochemical stress parameters in acute stroke. 30 patients are recruited in the stroke unit, blood samples are collected at fixed intervals during the first two days. patients are randomized to music listening and control.neuropsychological testing is performed in the acute phase and 6 months post-stroke.

outcome measures: nihss, stress hormone levels, questionnaires on mood and quality of life.

Eligibility criteria:
inclusion criteria: * hemispheric infarction * neurologically stable exclusion criteria: * previous neurological disease affecting the outcome * previous psychiatric disease affecting the outcome * substance abuse

Keywords: stroke music stress
chlorine dioxide versus saline for wound irrigation

Conditions: Wound - in Medical Care

Summary: this research is being done because the investigators are trying to examine the safety and effectiveness of this wound cleaning liquid, cacd (chlorine dioxide). the investigators are trying to see if this liquid has the ability to decrease infection rates and decrease the scarring effects from the healing process. in animal studies, cacd has been shown to decrease scar formation and decrease the risk of wound infections. cacd is also used for the treatment of burns to decrease infection rates and improve wound healing. cacd is not fda approved for this specific use, but it is fda and usda approved for reducing bacterial contamination on meat and food products for human consumption. in addition, an investigational drug (ind) application has been submitted to the fda for this study. the fda has approved the use of this solution for this study.


Eligibility criteria:
inclusion criteria: * 18-100 years old * simple laceration requiring irrigation \& sutures * patient has method of contact * patient is willing to return to ed in 3-4 mths exclusion criteria: * immunocompromised * consult required for repair * diabetic * require antibiotics
prefer managed ventricular pacing (mvp) for elective replacement

Conditions: Cardiovascular Diseases

Summary: the purpose of this study is to demonstrate the benefit of mvp in pacemaker and implantable cardioverter defibrillator (icd) patients with a history of right ventricular pacing.

a number of clinical studies (danish i, danish ii, david, most) over the past few years have shown that, in patients with intact atrioventricular (av) conduction, unnecessary chronic right ventricular (rv) pacing can cause a variety of detrimental effects, including atrial fibrillation (af), left ventricular (lv) dysfunction, and congestive heart failure (chf). these effects are believed to result from the mechanical dyssynchrony and ventricular chamber dysfunction that occurs with chronic, single-site, apical ventricular stimulation. therefore a new pacing modality, managed ventricular pacing (mvp), was designed to give preference to natural heart activity by minimizing unnecessary right ventricular pacing. this is accomplished by automatically switching between single chamber atrial and dual-chamber pacing based on specific patient needs. mvp is an atrial-based dual-chamber pacing mode that provides functional aai/r pacing with ventricular monitoring and back-up ddd/r pacing only as needed during episodes of av block. the reversibility of the detrimental effects caused by ventricular pacing has been initially investigated in small patient populations with short pacing durations in aai and needs further investigation.

Eligibility criteria:
inclusion criteria: * patients implanted with a dual chamber device (including atrial synchronous ventricular inhibited \[vdd\]) for a minimum time duration of 2 years * planned to be replaced or replaced with a device including the mvp feature * have had more than 40% ventricular pacing documented with their old device over a period of at least 4 weeks before enrollment or device replacement. * pacing should not be caused by a switch to the single chamber pacing (vvi) mode because of battery depletion * have signed the informed consent * have no need to change the pacing mode or the atrioventricular (av) intervals. exclusion criteria: * patients with a cardiac resynchronization therapy (crt) indication * permanent af * permanent av block * inability to complete follow-up visits at a study center. * unwillingness or inability to cooperate or give written informed consent, or the patient is a minor, and legal guardian refuses to give informed consent * planned cardiovascular intervention * inclusion in another clinical trial that will affect the objectives of this study * neurocardiogenic syncope as primary implantable pulse generator (ipg) indication.

Keywords: pacemaker or icd replacement
af septal pacing (clinical investigation plan)

Conditions: Paroxysmal Atrial Fibrillation; Persistent Atrial Fibrillation

Summary: the purpose of this non-randomized, non-controlled, acute, single-arm research study is to evaluate the feasibility to obtain a stable position of a ring of stimulation electrodes on the interatrial septum. the possibility to terminate atrial arrythmias will also be evaluated.

the evidence of treating af by pacing is limited, although these algorithms are of interest, since they appear to be safe and usually add little additional cost. using a computer model, a new dual-stage septal pacing has been developed.the proposed septal pacing algorithm could suppress af reentries in a more robust way than classical single site rapid pacing. the feasibility of pacing both atria simultaneously from a single lead placed in the interatrial septum has been previously demonstrated clinically. the septal pacing concept has also been successfully tested in a computer model of af and in a pig model . experimental studies are now needed to determine whether similar termination mechanisms and efficacies can be observed in humans. the purpose of this non-randomized, non-controlled, acute, single-arm research study is to evaluate the feasibility to obtain a stable position of a ring of stimulation electrodes on the interatrial septum

Eligibility criteria:
inclusion criteria: * patient referred to the center to undergo ablation of the pulmonary vein using radiofrequency (initial af ablation, or redo procedure). * in case of paroxysmal af the right atrium should be dilated as indicated by \> 29 ml mm2 or the left atrium should be dilated as indicated by \> 34 ml mm2. * patient is willing and able to cooperate with the study procedure. * patient is willing to provide the informed consent for their participation in the study. exclusion criteria: * patients under 18 years or over 80 years old. * women who are currently pregnant or have a positive pregnancy test. * patients with an implantable cardiac device. * patients who already underwent an af septal ablation procedure.
a retrospective analysis of cerefolin nac® in cognitively impaired patients

Conditions: Mild Cognitive Impairment

Summary: this retrospective analysis of de-identified data from 700 charts of consecutive patients from this patient population is to investigate the prevalence of hyperhomocysteinemia and associated metabolic abnormalities in this naturalistic grouping of patients with various stages of cognitive loss and diagnosed with various types of dementia.

a single-center, retrospective review of the medical charts of 700 de-identified elderly patients who underwent evaluation and treatment for cognitive loss including analysis of: laboratory values of interest: homocysteine, methylmalonic acid, crp, bnp, co2, tsh, fe/tibc, rpr/tppa/fta-abs, and if available, folic acid and b12 levels ordered by primary care providers. neuropsychological tests of executive function, memory and affect: * wechsler memory scale-revised (wms-r) or fourth edition (wms-iv) * logical memory -delayed recall, scaled score * visual reproduction-delayed recall, scaled score * shopping list test, delayed recall * trailmaking a and b tests * verbal absurdities subtest of the stanford binet, form l-m * proverbs test * memory orientation screening test * folstein mini-mental state exam * geriatric depression scale, 15 items sub-group analysis of mri volumetrics and pet scans when available. sequentially pulled from june 1, 2009 to september 2011

Eligibility criteria:
inclusion criteria: * individuals between the ages of 55 and 89 years old * meeting criteria for mild cognitive impairment or dementia with a minimum most score of 5 but not over 23 * has a minimum of 3 months evaluation * able to undergo testing for cognition and complete the gds exclusion criteria: * known allergy/intolerance to any ingredient in cerefolin nac® * substantial impediments to adherence, such as severe dementia without caregiver to administer medication * inability to swallow pill-form medication * unstable medical illness including cardiovascular, hepatic, renal, respiratory, endocrine, neurological, or hematological disease * hcy score lower than 11

Keywords: hyperhomocysteinemia dementia depression vitamin b12 mild cognitive impairment alzheimer's
impact of social distancing on bariatric versus non-surgical obese patients during covid-19 pandemic

Conditions: Diabetes Mellitus, Type 2; Obesity, Morbid; Bariatric Surgery Candidate

Summary: in response to the covid-19 pandemic, weight management programs and metabolic surgery have been deferred to contain the virus. quarantine and social distancing negatively impact dietary, exercise and psychological health of obese individuals. the study aims to evaluate the impact of social distancing measures on post-metabolic surgery patients compare to non-surgical obese patients and discuss potential strategies for management post covid-19.

in singapore, a nationwide partial lockdown, termed the "circuit breaker" was imposed from 7th april until 1st june 2020 in response to the covid-19 pandemic (appendix a). our study aims to evaluate the impact of social distancing and lockdowns during this circuit breaker period on our patients with obesity, either post-metabolic surgery (ms) or undergoing active medical management (mm), during the covid-19 pandemic in singapore. results will help inform and address the challenges in patient care that this pandemic has brought to light, its long-term implications on the management of the bariatric patient and discuss potential strategies for the management of a bariatric patient in a post covid-19 society. to the knowledge of this paper, this is the first study to compare the impact of covid on ms and mm patients which will allow understanding of unique stressors faced by ms patients this study adopted a cross-sectional survey design to evaluate the impact of lockdown social distancing measures on obese patients in singapore. the study conducted either face-to-face questionnaires in the clinic after lockdown for those who were not suitable for video consultation or questionnaires administered via telecommunication channels such as whatsapp

Eligibility criteria:
inclusion criteria: * obesity (bmi 30 kg/m2 and above) * english literate * mental capacity to make their own decisions exclusion criteria: * undergone bariatric surgery ≤ 6 months ago * have active eating disorders * pregnant or had given birth ≤ 6 months ago * admitted to hospital or tested positive for covid-19 * exhibit symptoms of active severe psychological and psychiatric conditions like psychosis, self-harm, suicide, hallucinations that may hinder them from providing accurate responses.
braingate2: feasibility study of an intracortical neural interface system for persons with tetraplegia

Conditions: Tetraplegia; Spinal Cord Injuries; Amyotrophic Lateral Sclerosis; Brain Stem Infarctions; Locked in Syndrome; Muscular Dystrophy

Summary: the purpose of this study is to obtain preliminary device safety information and demonstrate proof of principle (feasibility) of the ability of people with tetraplegia to control a computer cursor and other assistive devices with their thoughts.

the goal of the braingate2 research and development project is to identify the core methods and features for a medical device that could allow people with paralysis, including severe speech impairment, to recover a host of abilities that normally rely on the hands or on speech.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of spinal cord injury, brainstem stroke, muscular dystrophy, amyotrophic lateral sclerosis or other motor neuron disorders * complete or incomplete tetraplegia (quadriplegia) * must live within a three-hour drive of the study site * (there are additional inclusion criteria) exclusion criteria: * visual impairment such that extended viewing of a computer monitor would be difficult even with ordinary corrective lenses * chronic oral or intravenous steroids or immunosuppressive therapy * other serious disease or disorder that could seriously affect ability to participate in the study * (there are additional exclusion criteria)

Keywords: brain computer interface assistive device environmental control communication device quadriplegia tetraplegia
intravenous lidocaine and acute rehabilitation

Conditions: Pain, Postoperative; Opioid Consumption, Postoperative; Postoperative Fatigue

Summary: background: intravenous infusion of lidocaine may decrease postoperative pain and speed return of bowel function. the investigators therefore tested the hypothesis that including perioperative lidocaine infusion improves recovery from laparoscopic colectomy and shortens the duration of hospitalization. methods: forty patients scheduled for laparoscopic colectomy were randomly allocated to receive intravenous lidocaine (bolus injection of 1.5 mg.kg-1 lidocaine at induction of anesthesia, then a continuous infusion of 2 mg.kg-1.h-1 intraoperatively and 1.33 mg.kg-1.h-1 for 24 h postoperatively) or an equal volume of saline. all patients received similar intensive postoperative rehabilitation. postoperative pain scores, opioid consumption, and fatigue scores were measured. times to first flatus, defecation, and hospital discharge were recorded. postoperative endocrine (cortisol and catecholamines) and metabolic (leucocytes, c-reactive protein, and glucose) responses were measured for 48 h. data (median \[25%-75% interquartile range\] saline vs lidocaine groups) were analyzed using mann-whitney tests. p\<0.05 was considered statistically significant.


Eligibility criteria:
inclusion criteria: * asa i-iii * non-malignant disease exclusion criteria: * greater than 70 years * history of gastro-duodenal peptic ulcer or renal failure (contraindications to the use of nonsteroidal anti-inflammatory drug) * hepatic insufficiency * psychiatric disorder * steroid treatment * chronic treatment with opioid