Kornimate/medical-research-clean huggingface dataset:
l3/l4 high velocity low amplitude technique influence on baropodometric pressures in healthy young adults

Conditions: Healthy

Summary: in this double-blinded study, the objective is to determine the effects of bilateral high velocity low amplitude (hvla) technique on l3/l4 joint in baropodometric pressures in 60 healthy young adults.

the postural control it´s a fundamental aspect to understand the human´s capacity to perform activities. these balance is controlled by several mechanisms such as the proprioceptive system of muscles and articulation joints. it is known that the high velocity low amplitude (hvla) technique shows biomechanical and neurophysiologic effects. by saying that, it is importance to understand the effects of the lumbar manipulation on body´s weight distribution. therefore, there is going to be measure several variables such as center of pressure oscillation , plantar pressure distribution and plantar contact area using a pressure platform.

Eligibility criteria:
inclusion criteria: * individuals aged between 18-25 years old; * individuals with bmi between 18,5 and 24,9 kg/m2 exclusion criteria: * pregnancy; * with the follow conditions: lumbar discal hernia, spondylolisthesis with neurologic influence, narrowing of medullar canal, rheumatic disease, orthopaedic or neurologic conditions such as diminished sensibility, lack or absence of muscular strength, absence of patellar and/or aquilus reflexes; * history of chirurgical intervention either on lumbar or lower limbs in the past 6 months; * history of any trauma on the lumbar spine or lower limbs in the past 6 months; * any type of treatment on the lumbar in the previous month: that implicates physiotherapy, osteopathy, chiropractic, myofascial treatment, acupuncture or others; * medication that affects the vestibular system (dizziness, vertigo and humming) * pain during que experimental study; * difference between the length of the lower limbs: above 1.5cm;

Keywords: lumbar manipulation high velocity low amplitude (hvla) technique baropodometry osteopathy plantar weight distribution
hip fracture accelerated surgical treatment and care track (hip attack) trial

Conditions: Hip Fractures

Summary: hip attack is an international randomized controlled trial of 3000 patients with a hip fracture that requires a surgical intervention. this trial will determine the effect of accelerated medical clearance and accelerated surgery compared to standard care on the 90-day risk of mortality and major perioperative complication (i.e., a composite of mortality, nonfatal myocardial infarction, nonfatal pulmonary embolism, nonfatal pneumonia, nonfatal sepsis, nonfatal stroke, and nonfatal life-threatening and major bleeding).


Eligibility criteria:
inclusion criteria: * age ≥45 years; and * diagnosis of hip fracture during working hours with a low-energy mechanism (i.e., falling from standing height) requiring surgery. exclusion criteria: * patients requiring emergent surgery or emergent interventions for another reason (e.g., subdural hematoma, abdominal pathology requiring urgent laparotomy, acute limb ischemia, other fractures or trauma requiring emergent surgery, necrotising fasciitis, coronary revascularization, pacemaker-implantation); * open hip fracture; * bilateral hip fractures; * peri-prosthetic fracture; * therapeutic anticoagulation not induced by a vitamin k antagonist, unfractionated heparin, (e.g., administration of therapeutic low molecular weight heparin (lmwh) (\>6,000 u/24h) in the 24 hours prior to enrolment, or intake of any other non-reversible oral anticoagulant(s) for which there is no reversing agent available * patients on a therapeutic vitamin k antagonist with a history of heparin induced thrombocytopenia (hit); * patients refusing participation; or * patients previously enrolled in the study.

Keywords: perioperative outcomes
pre-emptive scalp infiltration with triamcinolone acetonide plus ropivacaine for post-craniotomy pain in children

Conditions: Pain; Postoperative Children

Summary: at present, pediatric postoperative analgesia has not been fully understood and controlled, particularly craniotomy surgery. on the one hand, professional evaluation of postoperative pain for young children is difficult; on the other hand, the particularity of craniotomy adds (such as consciousness obstacle, sleepiness, et al) disturbance to the pain assessment in children. although opioids administration is regarded as the first-line analgesic for post-craniotomy pain management, it may be associated with delayed awakening, respiratory depression, hypercarbia and it may interfere with the neurologic examination. for the avoidance of side-effects of systemic opioids, local anesthetics administered around the incision have been performed clinically. however, some studies revealed that the analgesic effect of local anesthetics was unsatisfactory due to its short pain relief duration, steroid as adjuvant can enhance postoperative analgesia and prolong postoperative analgesia time. as is reported that postoperative pain of craniotomy is mainly caused by skin incision and reflection of muscles, preventing the liberation of inflammatory mediators around the incision seems to be more effective than simply blocking nerve conduction.however, there has not been reported about local application of triamcinolone acetonide on scalp infiltration. thus, the investigators suppose that pre-emptive scalp infiltration with steroid (triamcinolone acetonide) plus local anesthetic (ropivacaine) could relieve postoperative pain after craniotomy in children.


Eligibility criteria:
inclusion criteria: -(1) age 2 to 12 years. (2) american society of anesthesiologists (asa) physical status i or ii. (3)participates with an anticipated fully recovery within 2 hours postoperatively. (4)informed consent by parent(s) and/or legal guardian. exclusion criteria: - (1) allergy to local anesthetics. (2) pediatric patients aged\>12 or \<2 years. (3) under medication with analgesic drugs. (4) psychiatric disorders. (5) uncontrolled epilepsy. (6) chronic headache. (7) peri-incisional infection. (8) coagulopathy or bleeding disorder. (9) patients who are expected to remain intubated and mechanical ventilation after surgery. (10) emergency craniotomies. (11) patients with cardiac insufficiency or severe kidney or liver diseases. (12) patients whose authorized surrogates are unwilling to participate in the study

Keywords: postoperative pain pre-emptive scalp infiltration triamcinolone acetonide
assessing neurovisual function in patients with cognitive impairment

Conditions: Glaucoma; Mild Cognitive Impairment; Glaucoma and Mild Cognitive Impairment; Healthy

Summary: the aim of this study is to measure fitness to drive in patients with a visual and a cognitive impairment. to do so, ocusweep is used in patients with glaucoma and mild cognitive impairment. the participants will be divided over four groups; patients with glaucoma, patients with cognitive impairment, patients with both and a healthy control group. differences in performance on ocusweep in the four different groups of participants are expected. these effects may be related to fitness to drive, which is why those results will be compared to traditional neuropsychological measures of fitness to drive. the hypothesis of the current study is that the ocusweep performance is related to performance on other measures of fitness to drive.


Eligibility criteria:
inclusion criteria: * be at least 65 years old * fit into one of the four groups of participants * no other eye diseases than glaucoma * still be able to and allowed to drive a car * be able to visit the turku driver's clinic for testing exclusion criteria: * a history of neurological disorders, depression or anxiety * motor problems * visual acuity less than 0.5 * score over 6 in geriatric depression scale questionnaire (gds 15)

Keywords: glaucoma mild cognitive impairment ocusweep reaction time neuropsychology dementia alzheimer's disease brain diseases
antibiotic treatment to patients with low back pain

Conditions: Back Pain

Summary: a large proportion of patients with low back pain (lbp) (80 %) are classified as "non-specific", due to the lack of a patho-anatomical diagnosis. this term is not satisfactory, since it implies uncertainty for both the patient and the clinician. modic changes have recently been identified as a pain giving patho-anatomical diagnosis for a considerable percentage (20-30 %) of lbp patients. the causes of these modic changes have not been determined conclusively but bacterial infection is among the plausible causes for those following a disc herniation. purpose the aim of this study is to assess the clinical effect of antibiotic treatment compared to placebo, in patients with lbp and modic changes following a lumbar herniated disc. design a double blind prospective clinically controlled trial. patients will be randomized by a blinded observer to either group a: 1 antibiotic tablet 45 patients group b: 1 placebo tablet 36 patients group c: 2 antibiotic tablets 45 patients group d: 2 placebo tablets 36 patients the patients will take the drug three times a day for 100 days.


Eligibility criteria:
inclusion criteria: * age between 18-65 years * previous lumbar herniated disc confirmed by mri * time since lumbar disc herniation more than 6 months less than 2 years * lbp in the area of l1 to l5, with an added low back pain rating scale of 6 or more * the present mri shows modic changes * positive springing test (spt) at the level of modic changes exclusion criteria: * allergy against antibiotics * the beck depression inventory \>7, * pregnancy * breast feeding * all kidney diseases * pending workers litigation or pension * danish as second language * fertile women who do not user safe anti conseption * reduced liver functions * reduced liver function due to previous treatment wiht amoxicillin/clavulanasid.

Keywords: low back pain,
pei regimen: a therapeutic option in small cell lung cancer? a monoinstitutional experience of 46 consecutive cases

Conditions: Small Cell Lung Cancer

Summary: abstract objectives combination chemotherapy is very active in small cell lung cancer (sclc), although no improvement in overall survival (os) has been done in the last 25 years , with cisplatin-etoposide (pe) still considered the world-wide standard, with an average median survival of about 7-8 months in patients with extended disease (ed). in 1995, a randomized trial of the hoosier group in 171 ed patients showed a significant advantage in overall survival in patients treated with pei (cisplatin, etoposide and ifosfamide), compared to pe. despite that, pei regimen has not become a commonly used regimen in sclc. materials and methods here we present a series of 46 consecutive patients (30 males and 16 females) with sclc that were treated at our institution with pei regimen: cisplatin 20mg/m2, etoposide 75mg/m2 and ifosfamide 1200mg/m2, day 1 to 4, every 3 weeks. patients received a total of 219 cycles of chemotherapy, with a mean of 4,7 cycles per patient. median age was 63 (range 59-70); performance status (ps) was 0 in 29 patients (63%), 1 in 13 patients (28%) and 2 in 4 patients (9%).


Eligibility criteria:
inclusion criteria: * histologically or cytologically proven sclc * measurable disease defined by recist criteria exclusion criteria:

Keywords: small cell lung cancer extended disease limited disease chemotherapy cisplatin etoposide ifosfamide
investigating myocardial remodelling in the failing human heart

Conditions: Heart Failure

Summary: despite improvements in therapy, heart failure is a disease with high mortality and accelerating prevalence. to improve patient care, it is necessary to better understand the features and underlying mechanisms of myocardial remodeling; how it manifests in vivo and its underlying cellular and extracellular changes. the relax study will offer insight into myocardial remodeling, by comprehensively assessing function and structure of failing human hearts, and investigate its underlying cellular and extracellular changes.


Eligibility criteria:
inclusion criteria: * eligible for heart transplantation * willingness to participate in the present study and ability to understand and sign the written informed consent exclusion criteria: * patients under the age of 18.

Keywords: mri heart transplantation heart failure pet
continuous intravenous lidocaine infusion versus placebo for rib fracture analgesia

Conditions: Rib Fractures

Summary: the current cornerstone of pain control for rib fractures is oral and intravenous opioids, especially in the form of patient-controlled analgesia (iv pca), which are are associated with multiple adverse effects including sedation, respiratory depression, cough suppression, and increased risk of delirium. in the past few decades, intravenous lidocaine infusion (ivl) has emerged as a new tool in the arsenal of multimodal analgesia. multiple randomized clinical trials have indicated that ivl is overall well tolerated and have shown other beneficial effects such as anti-inflammatory properties. to this date, there have been no published randomized clinical trials (rct) evaluating the effectiveness of ivl in management of traumatic rib fracture pain. therefore, the purpose of this study is to evaluate whether iv lidocaine infusion can provide improved pain control as demonstrated by decreased ome consumption at 24 and 48 hours compared to placebo in adult patients with acute traumatic rib fractures.


Eligibility criteria:
inclusion criteria: * all adult patients admitted to stanford health care with two or more acute traumatic rib fractures exclusion criteria: * hemodynamically instability * mechanical ventilation * polytrauma (defined as bone or organ injury outside the thorax) * pregnancy * incarceration * local anesthetic allergy or contraindications to lidocaine (stokes-adams syndrome, wolff-parkinson-white syndrome, or severe degrees of sinoatrial, atrioventricular, or intraventricular block) * chronic opioid use.
technical strategies for pancreatic fistula prevention after pancreaticoduodenectomy in high-risk pancreatic remnant

Conditions: Pancreatic Fistula

Summary: this trial will investigate what surgical technique between pancreaticogastrostomy and pancreaticojejunostomy with transanastomotic externalized drains is associated with the lowest rate of pancreatic fistula after pancreaticoduodenectomy in case of high-risk pancreatic remnants.

pancreatic fistula is the major determinant of outcome after pancreaticoduodenectomy. several strategies to reduce the burden of this complication have been proposed in the last decade. a definite answer about what is the best technique to approach a high-risk pancreatic stump is still needed. both pancreaticogastrostomy and pancreaticojejunostomy with transanastomotic externalized drains have been proposed in this setting, but often studies do not provide a reliable risk stratification and result are extremely variable. the aim of this trial is to evaluate what surgical technique, between pancreaticogastrostomy and pancreaticojejunostomy with transanastomotic externalized drains, is associated with the lowest rate of pancreatic fistula in case of high-risk pancreatic remnants. risk stratification will be provided through the fistula risk score, a clinical risk score that has been extensively validated.

Eligibility criteria:
inclusion criteria: * all the patients undergoing pancreaticoduodenectomy (only whipple or traverso) for all kind of pancreatic disease (benign, malignant or premalignant). * patients able to give their informed consent exclusion criteria * informed consent withdrawal * impossibility to undergo surgery for any reason * use of glues or biological matrices to protect the anastomosis * fistula risk score \< 7 * post-operative octreotide analogues administration (only prophylactic use, therapeutic use allowed) * wrong randomization

Keywords: pancreaticoduodenectomy pancreaticogastrostomy pancreaticojejunostomy stent transanastomotic drain
normalizing cervical intersegmental kinematics with spinal manipulative therapy

Conditions: Neck Pain

Summary: the broad long-term objective is to develop an objective biomarker for spinal health based on aberrant or abnormal movement patterns during functional activities to better target spinal manipulation therapy (smt) and other conservative treatments. the central hypotheses are a) that aberrant spinal motions and their location (area and level) are indicative of underlying spinal dysfunction, and b) that quantified 3d cervical spine intersegmental and global motion patterns during functional tasks can be used as a biomarker for subsequent clinical studies aimed at normalizing cervical kinematics. specific aim: determine the extent to which smt can modulate, or normalize, intersegmental motion in patients with neck pain. rationale: smt is a force-based biomechanical event whose hypothesized mechanism of action relies on moving the segment into the para-physiological zone, resulting in normalization of spinal kinematic function. hypothesis: severity of abnormal or aberrant motion, identified in those with np, will improve following smt. approach: participants with chronic mechanical neck pain will be recruited and randomized into one of three groups: 1) no treatment, 2) light massage (pseudo- sham), and 3) spinal manipulative therapy. using a repeated measures study design, metrics of quality of spinal motion will be compared before and after the prescribed intervention.


Eligibility criteria:
inclusion criteria: * nonspecific, mechanical neck pain equivalent to grades i or ii (bone and joint task force on neck pain and its associated disorders classification2 for \>12 weeks * ages 18 to 39 * pain intensity \>3 (0-10 scale) exclusion criteria: * american society of anesthesiology class iii conditions and/or serious mental health conditions * botox injections (which resulted in clinical relief) in the past 3 months * chronic opioid use * contraindications to spinal manipulation (e.g. cervical instability; complicating neurological conditions) spinal manipulation or mobilization of cervical spine in prior 6 months * ongoing non-pharmacological treatment for neck pain * history of cervical spine surgery * pregnancy, currently trying to get pregnant, lactation * contraindications to radiation exposure
clinical implications of genetic variations of venous stasis ulceration

Conditions: Venous Ulcers

Summary: currently, there is no standard approach for the treatment of patients with venous stasis ulcers, and no means of accounting for the genetic factors that may contribute to a patient's response to different therapeutic interventions. in order to determine whether, or to what extent, genetic profiling of venous stasis ulcers can stratify patients according to their potential for disease progression or healing, and guide preventive strategies and levels of therapeutic interventions, the study will involve retrospective genetic profiling of patients with a healed or persistent venous stasis ulcer as a means of determining the efficacy of current therapies, and to establish a future prospective evaluation of treatment algorithms based on genetic phenotype and variation. results obtained from the 2 aforementioned groups of participants will be compared with those of a control group of participants who have no history of venous ulcer nor peripheral vascular disease. .

a blood specimen will be drawn, medical and medication history taken, and wound/s will be assessed and followed for 2 years in regard to the enrollees w/active venous ulcer/s or healed venous ulcer/s. a venous duplex ultrasound of right and left lower extremities will be done at no cost, a blood specimen will be drawn, and medical and medication history will be taken in regard to control group enrollees.

Eligibility criteria:
group 1-active venous ulcer (ceap 6) \& group 2-healed venous ulcer (ceap 5) inclusion criteria: * \>/=18y.o. * active venous ulcer (ceap 6) * healed venous ulcer (ceap 5) exclusion criteria: * \<18 y.o. * inability to comply w/compression therapy * inability to maintain f/u schedule * abi (ankle-brachial index) \< 0.5 if pedal pulses are not palpable * inability to ambulate w/active ulcer (n/a for group 2) * diabetic w/abi \<0.5 * severe premorbid systemic disease such as pulmonary failure, heart failure, renal failure, or hepatic failure w/a life expectancy of \<1 year * chronic steroid therapy group 3-controls inclusion criteria: * \>/= 50y.o. * no reported clinical symptoms of venous disease * (ceap 0 or 1) exclusion criteria: * \<50y.o. * abi (ankle-brachial index) \< 0.5 if pedal pulses are not palpable * diabetic w/abi \< 0.5 * severe premorbid systemic disease such as pulmonary failure, heart failure, renal failure, or hepatic failure w/a life expectancy of \<1 year * chronic steroid therapy

Keywords: ulcers, venous, unna's boot
naturopathic treatment for the prevention of cardiovascular disease

Conditions: Cardiovascular Disease

Summary: this study is designed to test the ability of a comprehensive naturopathic approach to reduce important risk factors for the development of cardiovascular disease. treatment will take place over the course of one year and the comparator/control group will be followed by their medical doctors and be given conventional care.

interventions will consist of an individualized treatment approach guided by an expert panel of clinicians who treat patients with cardiovascular disease. these interventions will consist of a combination of dietary, lifestyle and specific recommendations for supplementation. as this is a pragmatic study, blinding will not be attempted nor is appropriate.

Eligibility criteria:
inclusion criteria: * 18 to 65 years old * cupw worker * prescreening indicates higher than normal tc/hdl ratio exclusion criteria: * experienced an mi or stroke within past 6 months

Keywords: cardiovascular disease naturopathic medicine natural health products lifestyle intervention dietary advice coronary heart disease