Kornimate/medical-research-clean huggingface dataset:
accuracy of pediatric emergency medicine providers in diagnosing hip effusions using point of care ultrasound

Conditions: Hip Effusion; Septic Arthritis; Transient Synovitis, Hip

Summary: the purpose of this study is to determine if pediatric emergency medicine providers can accurately diagnose a hip effusion using point-of-care ultrasound (pocus) compared to radiology ultrasound (radus).

the purpose of this study is to determine that the accuracy of trained pediatric emergency medicine providers to diagnose hip effusion using point-of-care ultrasound (pocus) is non-inferior to the reference standard of radiology ultrasound (radus). additionally, the investigators seek to compare how pocus performs against other clinical tests or investigations for the diagnosis of septic arthritis. the investigators hypothesize that trained em providers will be able to diagnose hip effusions with high (\>90%) accuracy compared to studies conducted by the department of radiology.

Eligibility criteria:
inclusion criteria: * age 18 years or younger * clinical presentation necessitating hip ultrasonography as determined by the evaluating clinician * study physician available at the time of presentation to ed * patient or legal guardian provides consent exclusion criteria: * children who present when a study physician is not available or those for whom consent is not given. * children who have had hip ultrasound imaging prior to their ed visit. children with prior hip/pelvis x-rays will not be excluded.

Keywords: point of care ultrasound hip effusion pediatric emergency medicine
altitude sickness prevention with ibuprofen relative to acetazolamide and treatment efficacy

Conditions: Acute Mountain Sickness

Summary: this double blind randomized trial will compare ibuprofen to acetazolamide for the prevention of acute mountain sickness. these drugs have never been directly compared for efficacy. the study population is hikers who are ascending at their own rate under their own power in a true hiking environment at the white mountain research station, owen valley lab (ovl) and bancroft station (bar), bancroft peak, white mountain, california.

the specific aim of this study is to evaluate if acetazolamide will be similar to ibuprofen (i.e. ibuprofen being non-inferior) in decreasing the incidence of acute mountain sickness (ams) in travelers to high altitude. it has been shown that ibuprofen taken 3 times a day 6 hours prior to ascent is effective for the prevention of ams, with a number needed to treat of 4, decreasing the odds of getting ams by a third. the efficacy appears to be similar to acetazolamide, with a nnt of 3 -8, although these two medications have not been directly compared in prevention of ams. acetazolamide is diuretic that is the only fda approved ams prophylactic medication and the most commonly used drug for ams prevention. although acetazolamide has been given a 1a indication, it has been shown to limit exercise capabilities at high altitude, and rapid ascent has been shown to attenuate its protective effects. ibuprofen has been given a iib recommendation by the wilderness medical society practice guidelines, in part because it has not directly compared to acetazolamide. it is unknown if a non-steroidal anti-inflammatory can provide protection from ams equivalent to acetazolamide.

Eligibility criteria:
inclusion criteria: 1. age 18-65 healthy non-pregnant volunteer 2. sea-level dwelling (live at low elevation \< 4000 ft) 3. arrange your own transportation to wmrs (bishop) by friday evening of study weekend 4. available for full study duration (friday pm-sunday am) exclusion criteria: 1. age \ 65, pregnant, live at altitude \>4000 ft 2. slept at altitude \> 4000ft within 1 week of study 3. allergic to acetazolamide, sulfa drugs, or non-steroidal anti-inflammatories 4. taking nsaids, acetazolamide, or corticosteroids 1 week prior to study 5. medical history of brain tumor, increased brain pressure, pseudotumor cerebri, vp shunts, hace, or hape.
timing of antibiotic prophylaxis for cesarean deliveries

Conditions: Infection

Summary: the current standard of care to prevent post partum infectious morbidities is to administer antibiotic prophylaxis to all women undergoing a cesarean delivery. the general practice is to administer the antibiotic immediately after the umbilical cord is clamped. this study will compare the incidence of post partum infectious morbidities when the extended spectrum prophylaxis given before the incision time vs. the time of cord clamp.

some studies suggest that administering the antibiotics prior to skin incision decrease the incidence of post partum infectious morbidities without increasing the risks to the baby from the exposure to the antibiotics. our investigation will validate these findings in a larger series of patients. we will be conducting a prospective controlled randomized trial that will compare both methods of antibiotic prophylaxis. all patients undergoing cesarean delivery will be eligible except for the patients with the diagnosis of chorioamnionitis. one group will receive cefazolin 1gm intravenous + azithromycin 500mg intravenous 30-60 minutes prior to incision. the second group will receive the same antibiotics immediately after cord clamp. the primary outcomes will be endometritis, wound infection, neonatal sepsis evaluations, proven cases of neonatal infection. secondary outcomes will be patients that required post procedure antibiotics, the duration of treatment for mother and neonate and the pattern of antibiotic resistance in microorganisms isolated and characteristics of the neonatal bowel flora.

Eligibility criteria:
inclusion criteria: * all patients undergoing cesarean delivery exclusion criteria: * patients diagnosed with chorioamnionitis at the time of decision * patients that require an emergency cesarean delivery * patients that decline participating on the study
sodium-lactate and traumatic brain injury

Conditions: Severe Trauma Brain Injury; Intracranial Hypertension

Summary: the purpose of this study is to compare the effect of bolus of either sodium-lactate or mannitol on the evolution of intracranial pressure (icp) during intracranial hypertensive episodes (ihe)

osmotherapy with mannitol remains the first treatment currently recommended to treat intracranial hypertension in severe head injury.however, this treatment in not always efficient and is associated with side-effects and a transitory action. hypertonic sodium-lactate, by its osmotic and energetic properties could be superior to mannitol to decrease icp. study objectives : to compare the effect of mannitol and sodium-lactate on icp at the fourth hour after the start of infusion during ihe in severe traumatic brain injury (tbi) (main endpoint) ; to compare the percentage of successfully treated episodes between both treatments and to compare the neurological status after one year of evolution (glasgow outcome score)(secondary endpoints) patients inclusion : adult severe tbi (glasgow coma score \< 9) \< 66 yrs exclusion criteria : polytrauma, bilateral fixed dilated pupils, motor score \< 4, neurosurgery, prolonged episode of hypoxia or arterial hypotension, 34 patients included from november 2003 to november 2004 and randomized into two groups : man group receiving mannitol 20% 100 ml in 15 min (17 patients, 36 episodes of ihe treated) and lac group receiving semimolar sodium-lactate 100 ml in 15 min (17 patients, 37 episodes of ihe treated). for ethical reasons a rescue treatment in a crossover fashion was performed for each episode of ihe when the randomized treatment failed. follow-up : one year after the tbi. study end : november 30, 2005

Eligibility criteria:
inclusion criteria: * age between 18 and 65 years * severe traumatic brain injury * prehospital glasgow coma scale \< 9 * rapid neurological worsening before admission exclusion criteria: * neurosurgical intervention * polytrauma * bilatéral fixed dilated pupils * motorscore \< 4 * prolonged episode of hypoxia or arterial hypotension * abundant rinorrhea

Keywords: traumatic brain injury intracranial pressure osmotherapy glasgow outcome score mannitol sodium-lactate
insulin variance throughout the day

Conditions: Insulin Sensitivity

Summary: this study is designed to determine whether the sensitivity of a participant's insulin varies from the morning to the evening.

study visit 1: about 16 hours - the participant will arrive to the visit fasting. the participant will have an oral glucose tolerance test which takes about 3 ½ hours. an iv line will be placed in the participant's arm vein for blood draw purposes and will remain there throughout the testing. a blood sample will be drawn 15 minutes and just before the participant will drink a sugar solution consisting of 75 grams of glucose. blood will be drawn at specific times after the participant consumes the drink. the participant will have a second oral glucose tolerance test which takes about 3 ½ hours. an iv line will be placed in the participant's arm vein for blood draw purposes and will remain there throughout the testing. a blood sample will be drawn 15 minutes and just before the participant drinks a sugar solution. blood will be drawn at specific times after the participant consumes the drink.

Eligibility criteria:
inclusion criteria: * are a healthy male or female * have a fasting blood sugar that is between normal and diabetes. * are between 18 and 70 years of age, inclusive. exclusion criteria: * are pregnant or breast-feeding a child * take a medication for diabetes * take a medication like cortisone that can change your blood sugar. * take a medication chronically that has not been at a stable dose for at least 1 month * take medication for psychosis that is known to change timing in the day - night cycle
use of aca 125 in patients with ovarian cancer: safety and immune response

Conditions: Ovarian Cancer; Fallopian Tube Neoplasms; Peritoneal Neoplasms

Summary: the purpose of this study is to use an immunologic approach following the treatment for recurrent disease in patients with ovarian, fallopian tube, or peritoneal cancer.

patients with epithelial ovarian, fallopian tube or peritoneal cancer who receive surgical cytoreduction and platinum/taxane containing chemotherapy have a significant chance of entering complete clinical remission but about 70% will eventually relapse. many patients respond to additional cytotoxic treatment with partial or complete responses, yet approximately 100% of these patients will ultimately progress. novel consolidation strategies following treatment for recurrent disease are needed and an immunologic approach is an attractive option.

Eligibility criteria:
inclusion criteria: * patients with epithelial carcinoma arising in the ovary, fallopian tube or peritoneum, stages i-iv. these patients must have received initial surgery and chemotherapy with at least one platinum based chemotherapy regimen. * patients must have relapsed and now have completed chemotherapy for recurrent disease within the last 6 weeks. * eligible patients may have asymptomatic residual measurable disease on ct scan, and/or may have an elevated ca-125, or may be in complete clinical remission. * patients must have adequate hematologic, renal and hepatic functions. exclusion criteria: * patients with any other active malignancy concomitantly * patients within 3 weeks of prior cytotoxic or investigational chemotherapy * patients within 4 weeks of prior radiotherapy * patients within 6 weeks of prior immunotherapy * patients who have received any prior anti-cancer vaccine

Keywords: ovarian cancer aca 125 6 or 9 vaccinations immune response fallopian tube cancer peritoneal cancer
the appropriate anticoagulation duration for chronic obstructive pulmonary disease with pulmonary thromboembolism

Conditions: COPD Exacerbation; PTE - Pulmonary Thromboembolism

Summary: anticoagulation is the most important treatment for pulmonary thromboembolism (pte). the thromboembolism risk is especially high in patients with chronic obstructive pulmonary disease (copd) exacerbations. however, there's no agreement on the most appropriate duration of anticoagulation in copd with pte to balance the risk of recurrence of thrombosis and bleeding. this randomized, controlled trial aims to evaluate the risk and benefit of prolonged anticoagulation compared with the regular 3-month anticoagulation in copd with pte.


Eligibility criteria:
inclusion criteria: * hospitalized patients due to chronic obstructive pulmonary disease exacerbation and diagnosed as newly developed pulmonary thromboembolism * regular anticoagulation for 3 months and got ct pulmonary angiography exclusion criteria: * patients with major bleeding during prior anticoagulation * patients need long term anticoagulation to treat other diseases * patients unwilling to receive prolonged anticoagulation
evaluation of the sarc-f score as a screening tool for undernutrition in a geriatric population

Conditions: Sarcopenia; Denutrition

Summary: to study the relationship between sarcopenia and undernutrition in adult patients over 70 years of age, and at the same time to define a threshold value for the predictive sarc-f score of undernutrition. hypothesis : the sarc-f score is correlated with malnutrition defined according to the following has criteria : moderate denutrition severe denutrition

the geriatric population is a population at risk, given the frequent and numerous comorbidities present. undernutrition is one of these, which is frequently associated with sarcopenia, that is, a decrease in muscle strength. its screening must be early to avoid complications (osteoporosis, fractures, infections ...) and given the cost it generates for society. however, the detection of undernutrition can sometimes be time-consuming and its criteria in default, such as in the presence of edema or obesity, for example. there is a score, the sarc-f, which allows to detect sarcopenia from a result greater than or equal to 4, but which does not allow direct detection of undernutrition. the primary objective is to evaluate the sarc-f score as a screening tool for undernutrition in a geriatric population, secondary objectives being to find a threshold value at this score, and also to estimate a prevalence of undernutrition in this population. it will be a cross-sectional exploratory study to evaluate a diagnostic tool, the sarc-f score, with comparison between cases and controls. the study will be conducted in a single center, a geriatric short-stay service. participation in the study will be offered to any patient admitted to the geriatric ward, those who meet the inclusion criteria and do not have exclusion criteria will have to complete the sarc-f questionnaire during their stay, and to do the handgrip test and impedancemetry performed by a third party. biological data (albumin, pre-albumin and c-reactive protein) and anthropometric data will be collected and analyzed to determine if the patient is malnourished or not, and the results of sarc-f will be compared between these 2 groups.

Eligibility criteria:
inclusion criteria: * 70 years and over * living at home or in nursing homes in puy-de-dôme * sent in short geriatric stay at the grand pré clinic by their general practioner, an emergency department or an ehpad exclusion criteria: * refusal to participate in the study * severe dementia preventing answering sarc-f questions * no fluency in the french language * patient with a pacemaker (contraindication of the use of impedancemetry)

Keywords: denutrition screening tool sarc-f score denutrition in geriatric population sarc-f score associated with denutrition
physical exercise controls gestational weight gain

Conditions: Pregnancy

Summary: an estimated two-thirds to three- quarters of women experience gestational weight gain outside of iom's 2009 recommendations: 40-60% of women experiencing excessive gain and 15-30% inadequate gain. not gaining the adequate weight gain is strongly associated with several maternal and fetal complications..

the aim of this study was to assess the role of a supervised exercise programme on the control of maternal gestational weight gain and its consequences.

Eligibility criteria:
inclusion criteria: * being healthy and able to exercise following american college of obstetricians and gynecologists (acog) guidelines * being able to communicate in spanish exclusion criteria: * obstetrician complications * being interested in the study after 18 weeks * not being regular in physical exercise program * younger than 18 years old

Keywords: exercise aerobic resistance training pregnancy maternal weight gain iom recommendations
study for evaluating life quality in patients with rhinoconjunctivitis

Conditions: Allergic Rhinoconjunctivitis

Summary: the purpose of ths study is to evaluate changes in life quality of patients affected by rhinoconjuntivitis with or without asthma after immunotherapy treatment. it is an observational, prospective and comparative study before-after immunotherapy treatment with a one year follow-up.


Eligibility criteria:
based on routine clinical practice inclusion criteria: * patients affected by allergic rhinoconjunctivitis sensityzed to one or several aeroallergens.although allergic rhinoconjunctivitis is the pathology under study, the inclusion of patients with mild concomitant asthma is allowed (gina 2013) * patients older than 12 years old * patients being subsidiaries of receiving allergen immunotherapy treatment * patients who obtained a prick test result ≥ 3 mm diameter to any aeroallergen. positive and negative control of the test should give consistent results. * patients with specific immunoglobulin e ≥ class 2 (cap/phadia) to any aeroallergen. exclusion criteria (based on routine clinical practice): * patients with severe asthma or forzed expiratoy volumen in 1 second fev1\< 70% even if the are pharmacologically controlled . * patients with: immunological, cardiac, renal or hepatic illnesses or any other medical condition that the investigator seems relevant so as to interfere with the treatment. * patients with a previous history of anaphylaxis * patients under treatment with tricyclic antidepressives, phenothiazines , β-blockers, or angiotensin converting enzyme inhibitors (acei) * female patients who are pregnant or breast-feeding

Keywords: allergy allergic rhinoconjunctivitis immunotherapy life quality adherence
comparison of standard treatment versus standard treatment plus extracorporeal life support (ecls) in myocardial infarction complicated with cardiogenic shock

Conditions: Myocardial Infarction; Shock, Cardiogenic

Summary: cardiogenic shock is currently the main cause of death after myocardial infarction and 50% of deaths occur within the first 48 hours. to limit the extent of the myocardial necrosis is the primary objective of the treatment in this context. the symptomatic treatment of the ventricular failure alone does not allow a reduction of mortality. the immediate prognosis is not significantly improved by the current standard of care, including early revascularisation and intra-aortic balloon counterpulsation. in order to improve the immediate prognosis, it seems necessary to limit the irreversible myocardial lesions and the systemic inflammatory response induced by an extended myocardial infarction (complement activation, cytokines production, inos expression, etc.). these objectives may be reached by a more extended utilization and availability of circulatory assistance methods. the investigators propose to compare, in a randomised multicenter study, two treatments of the myocardial infarction with cardiogenic shock among 44 patients: standard treatment versus ecls-impella +/- standard treatment. in june 2007, an amendment replaced the device ecmo by the use of impella intra-thoracic pump. this amendment has been approved by the ethic committee on july 7, 2007. in march 2009, a new amendment has been approved by the ec. this amendment allowed to revise the number of patients to enroll (reduced to 44) and this lead us to modify also the primary endpoint : variation of bnp levels between h0 and h24 (h0 defined as the nearest value of bnp level obtained before the randomization).showing a more important bnp levels decrease in the experimental group compared to standard treatment group, the investigators obtain an indirect argument to show a superior efficacy of the tested strategy.


Eligibility criteria:
inclusion criteria: * acute myocardial infarction complicated with cardiogenic shock * patient without contraindication to iabp or ecls-impella exclusion criteria: * patient with refractory cardiogenic shock * reperfusion \> 24 hours after the pain begins

Keywords: myocardial infarction cardiogenic shock extracorporeal life support-impella
intercostal nerve cryotherapy in patients undergoing minimally invasive pulmonary resection

Conditions: Cryotherapy Effect; Pain, Postoperative

Summary: this is a research study designed to test whether a treatment called intercostal nerve cryotherapy is an effective way to help control post-surgical pain for patients undergoing minimally invasive pulmonary resection. there are two treatment groups in this study, a cryotherapy group and control group. cryotherapy is a method of controlling pain by freezing nerves between the ribs that would transmit pain impulses to the brain.


Eligibility criteria:
inclusion criteria: 1. patients 18 year and older. 2. undergoing elective minimally invasive (vats or robotic) lung resection for nodules (wedge resection, segmentectomy, lobectomy). 3. performance status of 1 or 2. exclusion criteria: 1. patients with ejection fraction less than 40% 2. patients with creatinine greater than 1.5. 3. patients with child's b or c cirrhosis 4. patients on chronic narcotics for other reasons 5. patients diagnosed with fibromyalgia 6. patients who had previous thoracic surgery on the same side. 7. patients who cannot communicate in english. 8. patients unable to provide informed consent for the study.

Keywords: pulmonary resection cryotherapy