Kornimate/medical-research-clean huggingface dataset:
optimal level of peep in protective one-lung ventilation

Conditions: Video-assisted Thoracic Surgery; Postoperative Atelectasis; Positive End-expiratory Pressure

Summary: protective ventilation strategy has been widely applied in the field of thoracic surgery requiring one-lung ventilation to reduce postoperative pulmonary complications. low tidal volume, positive end-expiratory pressure (peep), and intermittent recruitment maneuver are key components of protective ventilation strategy. recent evidence suggests that a tidal volume of 4-5 ml/kg should be applied during protective one-lung ventilation. however, optimal level of peep is still unclear. this study aims to investigate optimal level of peep to minimize postoperative atelectasis by comparing modified lung ultrasound score in patients applied protective one-lung ventilation using peep of 3, 6, or 9 cm of water during thoracic surgery.


Eligibility criteria:
inclusion criteria: * patients undergoing video-assisted thoracic surgery under one-lung ventilation exclusion criteria: * moderate to severe obstructive/restrictive pattern in preoperative pulmonary function test * chronic kidney disease * coronary artery disease * pulmonary hypertension * bilateral lung surgery * conversion to thoracotomy * american society of anesthesiologists physical status iv or more * refusal to participate

Keywords: protective ventilation one-lung ventilation
dabigatran etexilate in extended venous thromboembolism (vte) prevention after hip replacement surgery

Conditions: Thromboembolism; Arthroplasty, Replacement, Hip

Summary: the objective of this study is to determine the comparative efficacy and safety of two oral regimens of dabigatran etexilate, compared to a standard subcutaneous regimen of enoxaparin, in prevention of venous thromboembolism in patients with primary elective total hip replacement surgery.


Eligibility criteria:
inclusion criteria inclusion criteria (selected): * patients (18 years or older) scheduled to undergo a primary, unilateral, elective total hip replacement * written informed consent exclusion criteria exclusion criteria (selected): * patients with an excessive risk of bleeding, for example because of history of bleeding diathesis major surgery or trauma within the last 3 months history of haemorrhagic stroke or any of the following intracranial pathologies: bleeding, neoplasm, av malformation or aneurysm clinically relevant bleeding or gastric / duodenal ulcer within the last 6 months treatment with anticoagulants within 7 days prior to joint replacement surgery or anticipated need during the study treatment period thrombocytopenia. * active malignant disease or current cytostatic treatment * known severe renal insufficiency * liver disease expected to have any potential impact on survival, or elevated ast or alt \> 2x upper limit of normal * recent unstable cardiovascular disease or history of myocardial infarction within the last 3 months * pre-menopausal women who are pregnant or nursing, or are of child-bearing potential and are not practising or do not plan to continue practising acceptable methods of birth control * allergy to radio opaque contrast media or iodine, heparins (incl. heparin induced thrombocytopenia) or dabigatran * contraindications to enoxaparin * participation in a clinical trial during the last 30 days
multi dimensional system for evaluating a preventive program for upper extremity disorders among computer operators

Conditions: Musculoskeletal Disorders; Upper Extremity Pain Chronic

Summary: computer settings points to a number of risk factors which may induce the development of work related msd (wrmsd). in light of the expanded use of computers and the increased occurrence of upper extremity (ue) wrmsd among computer operators various intervention programs have been developed and tested. nevertheless, many of these programs do not meet the criteria of quality and level of evidence. the main objective of this study is to use simultaneously a three dimensional (3d) kinematic analysis system, surface electromyography (semg) and fingertip force measurement system (flexiforce) while typing, to test the efficacy of primary and secondary preventive intervention programs aimed at reducing msd among computer operators. work hypothesis: significant score differences will be found on the evaluation parameters between the research group which underwent ergonomic training with biofeedback, the group without feedback, and the control group.the evaluated parameters will correlate with the appearance of msd symptoms and pain and will affect level of function. the study will include 66 participants, programmers and computer engineers. the participants will be assigned randomly to one of three groups: 1) participants will receive ergonomic training with biofeedback; 2) participants will receive ergonomic training without biofeedback; and 3) control group, without intervention. each group will consist of 22 participants. treatment efficacy will be tested both at work and in the motion lab. in the lab, 3d kinematic measurements and fingertip forces relevant to typing while entering a standard text will be measured. at the work site, anthropometric and measurements, work station measurements, posture observation and questionnaires about, psychosocial status, function and pain level will be filled the preventive program will be performed at the workstation after the preliminary data collection phase. the program will consist of one group meeting at the workplace for all employees participating in the study, and individual instruction at the workstation, including 3-6 meetings for the two research groups. data will be collected before and after the intervention program.


Eligibility criteria:
inclusion criteria: * subjects working more than four hours per day in front of a computer and are right-hand dominant. * healthy or suffering from diagnoses of ue-msd. (e.g. rotator cuff syndrome , lateral epicondylitis, cubital tunnel syndrome, carpal tunnel syndrome, flexor-extensor peri-tendinitis or teno-synovitis of the forearm-wrist region, de quervain's disease and nonspecific msd exclusion criteria: * participants suffering from orthopedic injury or neurological deficit (with the exception of the diagnosis mentioned above). * medical conditions that cause swelling of the joints or hand numbness (pregnancy, diabetes, heart condition, arthritis).

Keywords: ergonomics musculoskeletal symptoms kinematics
trial of velcade in patients with metastatic or locally recurrent nasopharyngeal carcinoma

Conditions: Nasopharyngeal Carcinoma

Summary: this study seeks to test the efficacy in terms of rates of disease response in metastatic nasopharyngeal carcinoma of the standard dose of velcade 1.3 mg/m2 given at the day 1,4,8,and 11 every 21 days schedule. the study uses a simons 2 stage design and will enroll between 15-25 patients. secondary endpoints studied include pharmacokinetics, toxicities, ebv viral load and molecular characterization of ebv in plasma.


Eligibility criteria:
inclusion criteria: * biopsy proven nasopharyngeal carcinoma - who type 3 (recurrence or metastases) * metastatic disease or locally recurrent disease not amendable curative therapy * patients must have measurable disease * least one (not more than a total of three prior lines of chemotherapy for metastatic or recurrent disease). this must include at least 1 prior line of platinum-containing chemotherapy. * an ecog performance status of 0-2 * absolute neutrophil count (anc) ≥1500/mm3 * hemoglobin 8g/dl (blood transfusion is allowed to correct hemoglobin level). * plt ≥ 75,000/mm 3 * total bilirubin ≤ 2 x upper normal limit (unl) * serum alt ≤ 5 x unl * serum creatinine ≤ 2 mg/dl * serum albumin ≥ 2.5 g/dl * no known history of brain or leptomeningeal metastasis. * ≥ 18 years of age. * estimated life expectancy ≥ 24 weeks. * for sexually active women of childbearing potential, negative pregnancy test within 21 days of enrolling on trial. * must be able to give informed written consent exclusion criteria: * patients who have not had at least 1 or more than 3 previous lines of treatment for metastatic or recurrent npc * prior bortezomib therapy * immunotherapy ≤ 4 weeks have elapsed prior to study entry * biologic therapy ≤ 4 weeks have elapsed prior to study entry * radiation therapy ≤ 4 weeks have elapsed prior to study entry * major surgery, or significant traumatic injury ≤3 weeks prior to study entry * other concurrent chemotherapy, immunotherapy, radiotherapy, or any other therapy or supportive care considered investigational * evidence of cns involvement * presence of \> grade 1 sensory peripheral neuropathy of any etiology or grade 1 with neuropathic pain of any etiology. * patients with significant local symptoms from metastases which is amenable to radiotherapy * history of allergic reactions attributed to compounds of similar chemical or biologic composition to bortezomib. * history of other malignancy ≤ 3 years prior to study entry, except for adequately treated basal cell, squamous cell skin cancer or cervical intraepithelial neoplasia. * uncontrolled intercurrent illness * patients who are pregnant or breast feeding (sexually active men and women of childbearing potential must use contraception during course of therapy and within 3 months of completion of trial) participation in another clinical trial involving therapeutic intervention within 4 weeks of enrollment. * known history of hiv
neo-adjuvant short course chemo-radiation therapy in locally advanced rectal cancer patients

Conditions: Neo-adjuvant Short Course Chemo-radiotherapy in Locally Advanced Cancer Rectum

Summary: * the primary objective of this trial is to assess the safety and feasibility of 5-fu when given concurrently with5 gy x 5 fractions imrt. * the secondary endpoint is to assess disease local control and the response rate after short course radiotherapy concurrent with dose escalation infusion 5-fu followed by mfolfox and delayed surgery.

neo-adjuvant radiotherapy is associated with the improvement of local control for rectal cancer. for locally advanced stage ii-iii resectable rectal cancer, either preoperative short-course radiotherapy of 25 gy in 5 consecutive days or long-course chemo-radiotherapy followed by radical total meso-rectal excision is recommended. the swedish rectal cancer trial has demonstrated the lower rate of early toxicity of short course radiotherapy when compared to chemo-radiation. short-course irradiation reduced the risk of local recurrence with evidence of overall survival improvement. short-course regimen is less expensive and more convenient, especially in centers with long waiting lists. two meta-analyses showed that short course is as effective as long course chemo-radiation in the management of locally advanced rectal cancer in the terms of sphincter preservation rates, down-staging, r0 resection, local control, and grade 3-4 toxicity. despite reduction in local-regional recurrence risk with neo-adjuvant short course radiotherapy, distant disease recurrence remains a substantial risk for patients with locally advanced disease. in a controlled randomized trial, a short course radiotherapy followed by consolidation chemotherapy prior to surgery yielded superior overall survival outcomes compared to chemo-radiotherapy, without significant differences in disease-free survival, nor local or distant disease control rates. the phase iii rapido and stellar clinical trials are also evaluating short course radiotherapy and consolidation chemotherapy. the stockholm iii trial was a 3-arm trial that compared short-course rt with the standard 1-week delay to surgery, short-course rt with a 4- to 6-week delay to surgery, and long-course chemoradiation with a 4- to 6-week delay to surgery. the results show similar outcomes between the groups, but delaying the surgery after short-course rt decreased the rates of high-grade toxicity and allowed for an expedited treatment program.

Eligibility criteria:
inclusion criteria: * pathological confirmed cancer rectum * age between 20-80 * clinical t3\\4 or node positive disease by mri exclusion criteria: * early stage cancer rectum * m1 disease confirmed by imaging or pathological

Keywords: ccrth
saint luc valve registry

Conditions: Valvular Heart Disease Stenosis and Regurgitation (Diagnosis)

Summary: the "cliniques universitaires saint luc" are one of the high specialized center in valvular heart diseases and valvular heart surgery. aortic stenosis, mitral and aortic regurgitation are the three valve pathology that are mainly frequent and studied. international guidelines in the management of valvular heart diseases are based on few limited old studies, mainly retrospective. and, a matter of concern is staying, about the timing of surgery for asymptomatic patients. a prospective registry will help us to better understand the pathologies and try to better define guidelines criteria for surgery.

with this prospective registry, all patients with aortic stenosis, mitral and aortic regurgitation will be followed. the investigators will find followed patients not yet operated or until surgery, but also patient after surgery according to the presence or abscence of guidelines criteria. it will permit to compare different kind of management of patients with valvular heart disease and to better define guidelines criteria for surgery.

Eligibility criteria:
inclusion criteria: * presence of aortic stenosis, mitral or aortic regurgitation at the time of an echocardiography at the "cliniques universitaires saint luc". exclusion criteria: -
treatment of hyperuricemia in patients with heart failure

Conditions: Heart Failure; Hyperuricemia

Summary: the study aims to assess (i) the contribution of ua itself to the chf pathophysiology and (ii) to test the effect of lowering ua by uricosuric treatment in chf.

hyperuricemia is often observed in patients with congestive heart failure (chf). it has been reported that hyperuricemia is related to exercise capacity, inflammation markers and diastolic dysfunction in such patients. in addition, hyperuricemia in chf relates to both symptomatic status (i.e. morbidity) as well as impaired prognosis (i.e. mortality). hyperuricemia is likely to play an important role in the pathophysiology of chf. up-regulation of xanthine oxidase (xo) activity in chf has been shown to contribute to higher uric acid (ua) in chf and the therapeutic concept of xo inhibition has shown beneficial effects in a number of surrogate markers in these patients. the xo inhibition accounts for substantial decrease in oxygen radical load, the latter is discussed as the main benefit of xo inhibition treatment in hyperuricemic patients. however, whether high uric acid itself is important or merely a marker of xo activity (and hence of increased radical accumulation) is currently under discussion. therefore, this study aims to assess (i) the contribution of ua itself to the chf pathophysiology and (ii) to test the effect of lowering ua by uricosuric treatment in chf.

Eligibility criteria:
inclusion criteria: * chronic heart failure * hyperuricemia exclusion criteria: * renal dysfunction (cr \> 2.0 mg/dl) * under treatment with anti-diabetic agents

Keywords: heart failure insulin metabolism pharmacology uric acid
management of closed diaphyseal displaced leg fractures in children and adolescents

Conditions: Tibial Fractures

Summary: most displaced tibial shaft fractures in pediatric patients have traditionally been treated after reduction by cast immobilization with good long-term results. recently, there has been a growing trend towards surgical intervention by osteosynthesis from the outset. this study aims to describe the results of orthopedic treatment and osteosynthesis from the outset.


Eligibility criteria:
inclusion criteria: * minor subject (under 18 years old) * subject treated at the hus, between june 1, 2004 and april 31, 2024, for a fracture of the displaced diaphysis of the tibia treated orthopedically or by osteosynthesis reviewed after more than 6 months * absence of written opposition in the medical file of the subject (and/or their legal representative if applicable) to the reuse of their data for scientific research purposes. exclusion criteria: * presence of opposition from the subject (and/or their legal representative if applicable) to the reuse of their data for scientific research purposes. * non-displaced and/or displaced fracture not located at the level of the tibial diaphysis * open fracture * incomplete or unusable file

Keywords: tibial fractures osteosynthesis, fracture closed fracture
efficacy of immunoglobulin plus infliximab for the early regression of coronary artery lesion in kawasaki disease

Conditions: Kawasaki Disease

Summary: this study evaluates the efficacy of the addition of infliximab to conventional initial treatment (intravenous immunoglobulin \[ivig\] plus aspirin) in early regression of coronary artery lesion in patients with kawasaki disease (kd).

this is a multicenter, open-label, blind-end, randomized controlled trial at 5 hospitals in shanghai, china. the kd children diagnosed within 14 days of onset according to the diagnostic criteria for kd released by american heart association (aha) in 2017 will be considered for participants in the trial. the patients meeting eligibility criteria will be randomly assigned in a 1:1 ratio to the control group (receiving 2 g/kg\*1 ivig and 30 mg/kg/d aspirin) or intervention group (receiving 2 g/kg\*1 ivig, 30 mg/kg/d aspirin and additional 5 mg/kg\*1 infliximab) based on the randomly block design (block sizes 4). baseline characteristics of each participant will be collected, including sex, age of onset, height, body weight, subtype of kd, fever days before initial ivig, other clinical manifestations, echocardiographic findings at enrolment, and a series of pre-ivig laboratory tests. two-dimensional echocardiography will be performed at least 7 timepoints: at admission, 2 weeks, 1 month, 3 months, 6 months, 9 months and 12 months after onset of kd to assess the coronary artery lesions.

Eligibility criteria:
inclusion criteria: * meeting diagnostic criteria for kd released by american heart association (aha) in 2017, including complete kd (also sometimes referred to as typical or classic kd) and incomplete kd ((also sometimes referred to as atypical kd); * diagnosed within 14 days of illness (including the 14th day, considering the first day of illness as the first day of fever); * not treated with ivig or other treatments for kd yet; * z score of any coronary artery of lmca, lad, lcx, the proximal and middle segment of rca ≥ 2 calculated based on the height, weight and coronary artery diameter measured by echocardiography; * aged between one month and 14 years. exclusion criteria: * receiving steroids or other immunosuppressive agents in the previous 30 days; * with a previous history of kd; * afebrile and all the inflammation indicators (including white blood cell count, crp, and erythrocyte sedimentation) become normal before enrolment; * with suspected infectious diseases including tuberculosis, sepsis, septic meningitis, peritonitis, bacterial pneumonia, varicella, influenza, ebv infection, etc; * with serious immune diseases such as immunodeficiency or chromosomal abnormalities; * unable to be followed up for at least 1 year.

Keywords: kawasaki disease infliximab coronary artery lesion
bppv with crp: single versus multiple cycles

Conditions: Benign Paroxysmal Positional Vertigo (BPPV)

Summary: unilateral posterior canal benign paroxysmal positional vertigo (bppv) cases will be randomized to treat with single or multiple cycles of canalith repositioning procedure.the treatment outcomes will be assessed at 7th and 28th days.

patients present with brief episodes of vertigo will be evaluated by dix-hallpike test. cases with positive dix-hallpike test, unilateral, posterior canal, will be randomized with block of four. either single or multiple cycles of canalith repositioning procedure will be performed. four treatment outcomes will be blindly assessed at 7 and 28 days.

Eligibility criteria:
inclusion criteria: 1. recurrent episodes of vertigo 2. 15 years of age or older 3. positive dix-hallpike test: unilateral, posterior canal exclusion criteria: 1. received vestibular suppressant within 6 hours 2. with other diseases or conditions cause of vertigo or central nervous system disease 3. with diseases or conditions contraindicate for dix-hallpike test or crp eg: cervical spine disease, back/ neck stiffness, retinal detachment 4. positive dix-hallpike test: bilateral, other canals 5. complications from crp eg: nausea, vomiting, canalith jam 6. cannot read the questionaire

Keywords: canalith repositioning procedure (crp) bppv
use of platelet-rich plasma in second-degree superficial burns

Conditions: Burns Degree Second

Summary: platelet-rich plasma (prp) obtained from the patient's blood has been used in many clinical and experimental studies, primarily wound healing, and successful results have been achieved. prp has been used in various studies in the treatment of burn wounds, and positive results have been obtained. however, investigators did not find any study or publication about the use of prp in second-degree superficial burns in our screening. investigators planned a prospective randomized controlled and multicenter study to investigate the positive effects of prp in the treatment of second-degree superficial burn.

the study was planned to be performed between 01.03.2020 and 01.04.2020 in health sciences university konya training and research hospital burn unit and health sciences university mogadishu-somalia recep tayyip erdogan training and research hospital general surgery clinics. patients hospitalized with a second degree superficial burn and treated with prp will be included in the study. primary purpose: to investigate the effectiveness of platelet-rich plasma in burn treatment secondary purpose: none. platelet-rich plasma has recently been used in medicine for the treatment of various diseases. in our study, patients hospitalized in our clinic with the diagnosis of second-degree superficial burn were randomized and divided into two equal groups. it was planned to treat the first group with prp, and the second group to be treated with a conventional method of dressing containing silver sulfadiazine cream. patients will be given clear and understandable information about the study. patients who agree to participate in the study will receive a consent form explaining that they have participated in the study voluntarily. the secretary will do randomization with the help of a computer program. a note stating which group the patient is in will be placed in a closed envelope. a randomization envelope will be opened in each patient before starting treatment. the primary endpoint of the study was determined as the day when the burn was epithelialized 100%. secondary endpoints are the deepening of the wound and the application of other treatment modalities, including surgery, or an infection in the burn area. in our power analysis, investigators found the number of patients as 80% power and 28 patients with an alpha value of 0.05. assuming that 10% of patients will be excluded during the study, investigators calculated that a total of 31 patients should be studied.

Eligibility criteria:
inclusion criteria: * having a second-degree superficial burn * to be over the age of 16. exclusion criteria: * patients under 16 * patients with a burn of more than 30% of the total body surface area. * patients with additional trauma with a burn wound. * diabetes mellitus, renal failure requiring dialysis and having decompensated heart disease * being pregnant and breastfeeding. * the patient does not want to participate in the study.

Keywords: prp burn