Kornimate/medical-research-clean huggingface dataset:
comparison of three tranexamic acid dose regimens in patients undergoing cardiac valve surgery

Conditions: Cardiac Surgical Procedures; Blood Transfusion; Tranexamic Acid

Summary: this study compares the effect of three different dose levels of tranexamic acid（txa）in reducing blood loss and transfusion requirements in cardiac valve surgery.

the effect of txa to reduce perioperative blood loss and blood transfusion has been well established in many trials, but the optimal dosage of txa in cardiac surgery has always been a problem of debate. this is a single-center randomized controlled trial to study different dose regimens of txa in cardiac surgery. we use three different dose levels of txa in cardiac valve surgery with cpb, and see if there are any differences in perioperative blood loss and transfusion requirements. serious adverse events and seizure attacks are also recorded until three months after surgery.

Eligibility criteria:
inclusion criteria: * patients aged between 18 to 60 years old scheduled for cardiac valve surgery (replacement or plasty) requiring cpb exclusion criteria: * known allergy to txa, combined cabg operation or other cardiac procedures other than valve surgery, previous cardiac surgery, ef\ 0.65, serious coagulation disorder, serious hepatic insufficiency, receiving antiplatelet therapy at any time within 7 days of surgery, receiving low molecular weight heparin at any time within 24 hours of surgery, and pregnancy.

Keywords: cardiac surgery blood transfusion blood loss tranexamic acid dose regimen
cdc prevention epicenters wake up and breathe collaborative

Conditions: Ventilator-associated Pneumonia

Summary: ventilator-associated pneumonia (vap) is a common complication of mechanical ventilation associated with significant morbidity, including prolongation of mechanical ventilation and increased icu and hospital length-of-stay. numerous strategies have been proposed to decrease the occurrence of vap among ventilated patients. most notably, optimizing the use of daily sedative interruptions and daily spontaneous breathing trials can improve sedative management, decrease ventilator time, improve outcomes for mechanically ventilated patients,and possibly decrease vap.combining daily sedative interruption with daily spontaneous breathing trials confers additive improvement in ventilator days, intensive care days, and possibly mortality compared to daily spontaneous breathing trials alone. the primary aim of this study is to determine the impact of an opt-out protocol for paired daily sedative interruptions and spontaneous breathing trials on vap rates using a new streamlined vap definition. the investigators will evaluate the responsiveness of cdc's proposed new surveillance definitions for ventilator-associated events to this quality improvement initiative. the study will be nested within the epicenters streamlined versus conventional vap surveillance study. nine of the 18 hospitals in the larger study will be participating in this intervention arm.


Eligibility criteria:
inclusion criteria: * all patients in participating units on mechanical ventilation for at least one calendar day beting treated with continuous sedatives or standing orders for sedatives. patients receiving mechanical ventilation through either an endotracheal or tracheostomy tube will be eligible. exclusion criteria: * moribund status or plans for withdrawal of life support

Keywords: ventilator-associated pneumonia
an evaluation of a new technique utilizing a biologic glue and tissue patch to seal the cut edge of the pancreas following removal of the tail of the pancreas

Conditions: Pancreatic Fistula; Distal Pancreatectomy Complications; Falciform Patch Pancreatic Closure; Fibrin Glue Pancreatic Closure

Summary: the purpose of this trial is to determine whether the use of an autologous falciform ligament patch combined with fibrin glue will reduce the rate of pancreatic fistula in patients completing distal pancreatectomy. the hypothesis for the current trial is: autologous falciform patch closure with fibrin glue will result in a 50% decrease in fistula formation postoperatively. the primary end point will be the development of pancreatic fistula using the isgpf definition of pancreatic fistula1. (drain output of any measurable volume of fluid on or after postop day #3 with an amylase content greater than three times serum amylase). secondary end points will include length of postoperative hospital stay, percutaneous intervention rates, re-operation rates, morbidity to include delayed gastric emptying, wound infection, intraabdominal abscess, postoperative hemorrhage and 30-day mortality.(bassi c, dervenis c, butturini g, et al. postoperative pancreatic fistula: an international study group (isgpf) definition. the journal of surgery, 2005;138:8-13).


Eligibility criteria:
inclusion criteria: 1. completion of a successful distal pancreatectomy with/without splenectomy 2. patient must have a pancreatic remnant in place 3. there must be a viable falciform ligament for creation of the autologous patch exclusion criteria: 1. patients undergoing total pancreatectomy 2. patients undergoing distal pancreatectomy who have previously completed a right sided resection of the pancreatic head, uncinate and neck 3. failure to sign informed consent 4. pregnant patients 5. patients in whom previous surgery has eliminated the falciform ligament, i.e. previous liver resection

Keywords: pancreatectomy fistula fibrin glue falciform patch surgery complications
effects of gastrostomy and oral tube feeding on patients with dysphagia after stroke

Conditions: Stroke, Ischemic

Summary: the goal of this clinical trial is to compare the differences in swallowing function, quality of life and nutritional status between ischemic stroke patients with dysphagia using intermittent oro-esophageal tube and gastrostomy. patients will be randomly divided into an oral tube group and a gastrostomy group, all receiving routine rehabilitation treatment. on this basis, the oral tube group will use intermittent oro esophageal tube for enteral nutrition support, while the gastrostomy group will use gastrostomy. researchers will compare changes in swallowing function, quality of life and nutritional status of two groups of patients before and after the study to see if intermittent oro-esophageal tube can improve the quality of life and nutritional status between ischemic stroke patients compared gastrostomy.

this study will last 15 days for each patient. the goal of this clinical trial is to compare the differences in swallowing function, quality of life and nutritional status between ischemic stroke patients with dysphagia using intermittent oro-esophageal tube and gastrostomy. patients will be randomly divided into an oral tube group and a gastrostomy group, all receiving routine rehabilitation treatment. on this basis, the oral tube group will use intermittent oro esophageal tube for enteral nutrition support, while the gastrostomy group will use gastrostomy. researchers will compare changes in swallowing function, quality of life and nutritional status of two groups of patients before and after the study to see if intermittent oro-esophageal tube can improve the quality of life and nutritional status between ischemic stroke patients compared gastrostomy.

Eligibility criteria:
inclusion criteria: * age\>18 years. * meeting the diagnostic criteria for ischemic stroke . * dysphagia confirmed by videofluoroscopic swallowing study. * clear consciousness. * no history of prior stroke. * stable vital signs. exclusion criteria: * use of tracheostomy tubes. * dysphagia that might be caused by other diseases that might cause dysphagia, such as head and neck tumors, traumatic brain injury, myasthenia gravis, etc. * complicated with severe liver and kidney failure, tumors, or hematological disorders. * simultaneously in need to undergo other therapy that might affect the outcomes of this study. * pregnant or nursing females.
no resistance after long term treatment seretide

Conditions: Asthma

Summary: this multi centre, double blind, comparator controlled, parallel group study is to determine whether asthma treatment with high doses of fluticasone propionate (fp) redirects a th2/ eosinophil response towards a more treatment resistant neutrophil/ monocyte response and whether this occurs to a lesser extent in asthmatic subjects treated with the combination product of salmeterol and fluticasone propionate (sfc). the primary endpoint is the mean change in priming of blood neutrophils assessed by marker a17. after a run-in period of 4 weeks subjects will enter a 24 weeks high dose treatment (fp 500 mcg bd) or a 12 week medium-dose treatment with fp 250 mcg bd followed by a 12 week treatment with sfc 50/ 250 mcg. at the visits lung function measurements, act, eno measurements and a blood sample will be performed. a total of 50 randomised subjects are planned to be recruited in this study


Eligibility criteria:
inclusion: * positive skin prick test * history of asthma (gina) * regular treatment with fp with/without laba at least 4 weeks before visit 1 * history of recurrent episodes of wheezing, breathlessness, chest tightness and/ or coughing in the previous year. * able to use a diskus™ inhaler * able perform reproducible lung function tests at visit 1 inclusion criteria treatment period: * fev1 % predicted \> 70% * act score \< 25 after run-in period exclusion criteria run-in period: * hospitalised for asthma within 4 weeks prior to visit 1 * acute upper respiratory tract infection or a lower respiratory tract infection within 4 weeks prior to visit 1 * oral, parental or depot corticosteroids within 4 weeks prior to visit 1 * hepatic impairment or other significant disease exclusion criteria treatment period: * non-compliance (\< 70%)

Keywords: asthma fluticasone propionate salmeterol/fluticasone propionate combination product innate immune response neutrophil priming
can malnutrition be prevented in patient with colorectal cancer stage dukes d?

Conditions: Colorectal Neoplasm

Summary: the purpose of this randomised intervention study is to investigate to what degree patients with colorectal cancer benefit of dietary counselling regarding nutritional status, oncologic treatment and quality of life.


Eligibility criteria:
inclusion criteria: * metastatic colorectal cancer * histological verified cancer * age \>18 years exclusion criteria: * cognitive reduction * confusion * not able to answer questionaire

Keywords: dietary intake dietary counseling weight loss body composition resting energy expenditure quality of life
a two-arm, multi-centre clinical evaluation of the xtag gastrointestinal pathogen panel

Conditions: Infectious; Colitis; Gastroenteritis

Summary: the xtag gastrointestinal pathogen panel (xtag gpp) is a pcr-based assay to detect the presence or absence of gastrointestinal (gi) pathogens from human stool specimens. the objective of this study is to establish diagnostic accuracy of the xtag gpp.

the xtag gpp assay is a qualitative nucleic acid multiplex test intended to simultaneously detect and identify bacterial (and toxins), viral, and parasitic pathogens extracted from human stool specimens collected from patients with signs and symptoms of infectious colitis or gastroenteritis. the objective of this study is to establish the diagnostic accuracy of xtag gpp through a multi-site, method comparison study on prospectively collected, left-over, and anonymized stool specimens. the prospective sample set will also be supplemented with pre-selected archived left-over specimens (for low prevalence targets only). diagnostic accuracy will be expressed in terms of clinical sensitivity and specificity for each target.

Eligibility criteria:
inclusion criteria: * the specimen is stool. * the specimen is from a pediatric or adult, male or female subject who is either hospitalized, admitted to a hospital emergency department, visiting an outpatient clinic or resident of a long-term care facility. * the specimen is from a patient exhibiting clinical signs and symptoms of infectious colitis or gastroenteritis. exclusion criteria: * the specimen is a preserved stool, stool in cary-blair media or rectal swab.

Keywords: stool feces gastrointestinal pathogen panel xtag gpp infectious colitis gastroenteritis detection
placental protein 13 serum endoglin and uterine doppler indeces as predictors of pre-eclampsia

Conditions: Preeclampsia

Summary: 50 pregnant females were divided in two groups, twenty five as a control group and twenty five as high risk group; they were subjected to uterine artery doppler, measurement of maternal serum and detection of (mthfr) gene polymorphisms in first trimester at 11 to 14 weeks of gestation, all pregnancies were followed until 40 weeks for development of pre-eclampsia

50 pregnant females were divided in two groups, twenty five as a control group and twenty five as high risk group; they were subjected to uterine artery doppler, measurement of maternal serum (pp-13) and detection of (mthfr) gene polymorphisms in first trimester at 11 to 14 weeks of gestation, all pregnancies were followed until 40 weeks for development of pre-eclampsia

Eligibility criteria:
inclusion criteria: * pregnant women at 11 to 14 weeks of gestation exclusion criteria: * fetal anomalies other medical diseases as diabetes mellitus, renal or liver diseases

Keywords: preeclampsia placental protein 13 uterine artery doppler
the contribution of internal maternal resources to creation of motherhood. comparison among mothers to twins and singleton

Conditions: Preterm Birth

Summary: delivery of twins or preterm infant is a very stressful episode to mothers. the purpose of this study is to characterize maternal psychological resources in dealing with this situation and compare it to mothers giving birth to singleton at term


Eligibility criteria:
inclusion criteria: * study group: mothers who give birth to twins or preterm infants * control: mothers who give birth to singleton, full term infants exclusion criteria: * none

Keywords: delivery of preterm infant and/or twins
pre-clinical models for mesenchymal stem cell therapy in hemophilic arthropathy

Conditions: Hemophilia A; Hemophilia B; Arthropathy

Summary: hemophilia is a constitutional coagulation disorder responsible for a hemorrhagic phenotype in patients from an early age. hemarthrosis is one of the most frequent complications in hemophiliacs and leads to the development of severe and early arthropathy, sometimes as early as childhood. to date, there is no curative treatment for these joint disorders and preventive treatments are insufficient to completely prevent joint degradation. mesenchymal stem cells have been shown to be of therapeutic interest in the management of pathologies such as osteoarthritis and inflammatory arthritis through their anti-inflammatory, regenerative and anti-apoptotic effects. hemophilic arthropathy is a separate condition at the border of these two diseases our study aim to show pre-clinical interest of mesenchymal stem cell therapy in hemophilic arthropathy


Eligibility criteria:
inclusion criteria: * hemophilia a or b adult patient, with or without arthropathy * heathly control exclusion criteria: * antiinflammatory drug use * immunosuppressive treatment or condition

Keywords: mesenchymal stem cells healthly control
18f-fdg pet imaging analysis of antiepileptic drug response in bects

Conditions: Benign Epilepsy With Centrotemporal Spikes

Summary: this original article is a novel investigation on the metabolic characteristics of different patterns of antiepileptic drug (aed) responses in benign epilepsy with centrotemporal spikes (bects) patients using 18f-fdg pet imaging. in this study, we demonstrated remitting-relapsing group showed more widespread hypo-metabolism regions than aed responders. results indicated that metabolic differences had the ability to distinguish the remitting-relapsing patients from aed responders. 18f-fdg pet could be used as a marker to infer the current seizure activity of bects. we think that the established hybrid model based on pet and clinical features may be a critical reference for better personalized medication in patients with bects.

purpose the current drug treatment of benign epilepsy with centrotemporal spikes (bects) mainly depends on the clinical experience of physicians. this study aimed to investigate different patterns of antiepileptic drug (aed) responses in patients with bects using 18f-fluorodeoxyglucose positron emission tomography (18f-fdg pet) imaging for better personalized medication. methods a total of 55 patients with bects (36 aed responders, 19 remitting-relapsing patients) and 23 pseudo-controls who underwent 18f-fdg pet imaging were retrospectively included. the group comparison was performed to investigate metabolic differences among aed responders, remitting-relapsing patients and pseudo-controls. three different logistic regression models were employed to distinguish remitting-relapsing patients from aed responders based on clinical features, 18f-fdg pet images and a hybrid of both. ten aed responders who reduced aed dose and one remitting-relapsing patient who relapsed within one month after pet examination were included in the model evaluation.

Eligibility criteria:
inclusion criteria: * 1.clinical diagnosis of bects; 2. aging between 6 and 18 years ; 3.taking mri and eeg examination; 4. taking aeds as prescribed; 5. continuous 12-month clinical follow-up after 18f-fdg pet examination; 6.the last seizure occurring earlier than 24 h before 18f-fdg pet study exclusion criteria: * 1.any history of neurological disorders, such as head trauma, tumor or infarct

Keywords: benign epilepsy with centrotemporal spikes glucose metabolism positron emission tomography machine learning
efficacy of 3 weekly injections of hyaluronate in patients with ankle osteoarthritis

Conditions: Osteoarthritis

Summary: the aim of this study was to investigate the efficacy and safety of three weekly intraarticular injections of hyaluronate (ha) in patients with unilateral ankle osteoarthritis (oa).

viscosupplementation with 3 to 5 weekly hyaluronate injections is a well-established treatment option in knee osteoarthritis. previous studies reported that five weekly hyaluronate injections were safe and effective for the treatment of ankle osteoarthritis. however, the effect of three weekly injections has rarely been investigated. besides, no study to date has assessed whether balance function would change after ha injections in patients with ankle oa. the purpose of this study was to evaluate the efficacy and safety of three weekly injections of sodium hyaluronate (hyalgan) in patients with unilateral ankle osteoarthritis. pain, physical function and balance will be assessed as parameters for the effectiveness.

Eligibility criteria:
inclusion criteria: * were 18 years of age or older, reported unilateral ankle pain for at least 6 months and had either reported no significant benefit from conservative treatment (rest, physical therapy, orthoses or pain medications etc.) or were unable to tolerate side effects of medications * ankle radiographs taken within 6 months were equivalent to grade 2 or 3 according to the kellgren-lawrence grading system (grade 2, definite osteophytes and possible narrowing of joint space; grade 3, moderate multiple osteophytes, definite narrowing of joint space, some sclerosis and possible deformity of bone contour)22 * had a current total aos score (described below) of \> 3 and \< 9 (possible range, 0-10) * were normally active, not bedridden or confined to a wheelchair, and were able to walk 30 meters without the aid of a walker, crutches or cane * were willing to discontinue all nonsteroidal anti-inflammatory drugs (nsaids) or other analgesic medication (except for rescue medication) for the duration of the study * did not receive physical therapy or trial of shoe modifications or orthotics during the study period exclusion criteria: * pregnant and lactating women * bilateral ankle oa requiring treatment of both ankles * chronic ankle instability * lower leg trauma other than within the ankle * previous orthopedic surgery on the spine, hip or knee * presence of active joint infections of foot or ankle * previous surgery or arthroscopy on the ankle within 12 months * intraarticular steroid or ha injection in the treated ankle within the past 6 months * treatment with anticoagulants or immunosuppressives * history of rheumatoid arthritis, gout, or any other inflammatory arthropathy * history of avian protein allergy * presence of other comorbidity (neoplasm, diabetes mellitus, paresis, recent trauma, etc) or poor health status that would interfere with the clinical assessments during the study

Keywords: ankle joint balance hyaluronic acid osteoarthritis
perception in parkinson's disease

Conditions: Parkinson's Disease; Perception; Visual Hallucination

Summary: the investigators plan to examine the relation of perceptual variables-basic vision, unusual perceptual experiences(including but not limited to visual hallucinations)-to relevant functional variables such as cognition, mood, and alertness/sleepiness in an online sample of persons with parkinson's disease (pwpd). it is hypothesized that unusual perceptual experiences will relate significantly to the selected variables. participants do not need to experience visual hallucinations to be able to participate in this study. this is an observational study only, and not an interventional study.

for this study, the investigators propose to conduct an online study of pwpd (proposing a total of 60 participants) to examine the relations among variables that may relate to perception in pd. those pwpd who express interest will be sent a link to an online survey (qualtrics). the investigators will collect demographic and health information, followed by questionnaires assessing unusual perceptual experiences, mood, motivation, sleep, fatigue and quality of life. the survey should take roughly 45 minutes to an hour to complete. compensation: a $20 amazon gift card will be offered to those who complete the survey all the way through with good effort.

Eligibility criteria:
inclusion criteria: * participants must be at least 40 years old * have a self-reported diagnosis of idiopathic pd * be proficient english speakers * have functional vision * have internet access, and access to a desktop computer or laptop exclusion criteria: * self-reported poor vision (non-functional range) * lack of access to internet and either a desktop computer or laptop