Kornimate/medical-research-clean huggingface dataset:
retroclavicular approach vs infraclavicular approach for plexic bloc anesthesia of the upper limb

Conditions: Hand Injury

Summary: locoregional anesthesia provides several advantages over general anesthesia in terms of postoperative pain, decreased postoperative opioid needs and reduced recovery time for patients undergoing orthopaedic surgery. for upper limb surgery, the coracoid infraclavicular brachial plexus block is generally preferred because of its simplicity and effectiveness but, needle visibility remains a challenge because of the angle between the ultrasound beam and the needle. the retroclavicular approach for brachial plexus anesthesia requires an angle between the needle and the ultrasound beam that is less steep than the angle required to perform an infraclavicular coracoid block. this approach has already been proven effective and safe in the past. the general objective is to provide a formal comparison between the retroclavicular approach and coracoid infraclavicular approach for brachial plexus anaesthesia. this study will delineate the differences between the two techniques.

investigators aim is to compare both techniques in terms of scanning time, needling time, total anesthesia time, needle visibility, block needle passes, block success and early and late complications. investigators made the hypothesis that, while providing similar efficacy and better needle visualisation than coracoid infraclavicular block, performance time of retroclavicular block will not exceed the performance time of its comparator. this study is designed as a prospective randomized non-inferiority trial. two groups of non-consecutive patients will be randomly assigned to either retroclavicular or coracoid infraclavicular block. this study will be carried out in three different centres simultaneously. the multicentre trial will be conducted in two university hospitals (centre hospitalier universitaire de sherbrooke \[chus\] hôtel-dieu/fleurimont and centre hospitalier de l'université laval \[chul\] in quebec city) and a community hospital (cowansville). the third participating establishment, brome-missisquoi-perkins hospital, is located in cowansville, a peripheral city of 15,000 people.

Eligibility criteria:
inclusion criteria: * elective or urgent surgery of the hand, wrist, forearm or elbow. * age \>18 years old. * asa (american society of anesthesiologists) class 1, 2 and 3. * able to provide valid written consent. * minimum body weight of 50 kg, despite bmi exclusion criteria: * patient refusal. * previous surgery or gross anatomical deformity of the clavicle. * systemic or local infection at needle entry point. * coagulopathy. * severe pulmonary condition. * local anaesthetic allergy. * pre-existing neurologic symptoms in the ipsilateral limb. * pregnancy. * surgical request of an indwelling catheter for post-operative analgesia

Keywords: brachial plexus regional anesthesia infraclavicular retroclavicular parasagittal upper limb surgery ultrasound guided block coracoid
effect of parecoxib on postoperative shoulder pain after gynecological laparoscopy.

Conditions: Anti-Inflammatory Agents, Non-Steroidal; Pain, Postoperative; Laparoscopy

Summary: this prospective, double blind, placebo-controlled, parallel group study will be conducted in the first affiliated hospital of sun yat-sen university in guangzhou, china. patients aged 18-65 (asa i-ii) undergoing elective gynecologic laparoscopic surgery with general anesthesia will be involved in this study. according to previous studies and our pilot trial, the sample size was estimated to be 120 subjects. all eligible patients will be randomly assigned to one of three groups: group a (single parecoxib) receiving parecoxib 40mg at 30min before the end of surgery; group b (multiple parecoxib) receiving parecoxib 40mg at 30min before the end of surgery, at 8h and 20h after the surgery, respectively, and group c (control group) receiving normal saline. all patients will be managed by a standard propofol-remifentanil based total intravenous anesthesia protocol. the incidence and intensity of shoulder pain at rest and with motion will be evaluated by an independent doctor blinding to medication and grouping using visual analog scale (vas) at 6h, 24h and 48h postoperatively. other types of pain (e.g. trocar wound and visceral pain), side effects (such as postoperative nausea and vomiting, itching, dizziness, and oversedation) will be assessed as well. at the end of the observation, the intensity of the maximum pain will be recorded, and the effect of shoulder pain on the four variables regarding to quality of life (activity, mood, walking and sleep) will be assessed using modified brief pain inventory(bpi) questionnaire.


Eligibility criteria:
inclusion criteria: * females age 18-65yr * american society of anesthesiologists (asa) physical status classification i-ii * body mass index(bmi) 18-25kg/m2 * scheduled for elective gynecologic laparoscopic surgery exclusion criteria: * patients with a history of severe cardiac, pulmonary, hepatic, renal disease, chronic drug or alcohol abuse; * the presence of preoperative shoulder pain or any chronic pain syndrome, long-term use of analgesics; * allergy or contraindications to nonsteroidal anti-inflammatory drugs (allergy, peptic ulcer disease, gastroesophageal reflux disease, renal insufficiency, coagulopathy) and any other drugs used in the study; * those whose pain evaluation was judged unreliable
gardasil versus cervarix in the treatment of warts

Conditions: Verruca Viral

Summary: warts are common, benign, epidermal proliferations caused by hpv infecting skin and mucous membranes. treatment of warts poses a true challenge despite existing variable therapeutic modalities, whether destructive or immunotherapeutic. human papilloma virus (hpv) vaccines are fda approved for the prevention of genital warts and wart related precancerous and cancerous lesions but they are not indicated for treatment of preexisting warts yet

approximately 35% of viral warts tend to be recalcitrant either showing no response to treatment or having prompt recurrences after treatment, causing frustration for both patients and physicians. success rates vary significantly across patients and across different therapeutic interventions ranging from 7% to 90%. immunotherapy is proposed to enhance virus recognition by the cell mediated immunity, which allows the clearance of both treated and untreated warts and helps to prevent recurrences through induction of a long-term acquired immunity to hpv. few reports suggest the possibility of using quadrivalent or bivalent hpv vaccines as therapeutic modality rather than only preventive modality. this is a randomized controlled study to assess the efficacy and safety of quadrivalent and bivalent hpv vaccines in the treatment of warts

Eligibility criteria:
inclusion criteria: * adult patients with recalcitrant multiple warts of any type. warts were considered recalcitrant if they persisted for at least 6 months without any response to 2 different therapeutic modalities or more. * immunocompetent patients. * patients who do not receive any treatment of warts for at least 1 month before the start of study. * patients who are able to understand and follow the study protocol and approve to sign the informed consent exclusion criteria: * patients with acute febrile illness. * past history of asthma. * allergic skin disorders, such as generalized eczema, or severe urticaria. * pregnancy or lactation * history of hypersensitivity to the treatment vaccines. * children * immunocompromised patients * patients unable to follow the study protocol
treatment resistant bipolar depression

Conditions: Bipolar Depression

Summary: to determine if adding escitalopram to current mood stabilizer (ms) or atypical antipsychotic (aa) will improve in rates similar to or better than adding a placebo (inactive pill)in resistant bipolar patients.


Eligibility criteria:
inclusion criteria: * age 18 or older * diagnosis of bipolar disorder and currently be in depressive state, and not responded to mood stabilizer or atypical antipsychotic alone or combined with an antidepressant medication. exclusion criteria: * pregnant or breastfeeding * history of seizure disorder or other unstable medical condition * received electroconvulsive therapy or transcranial magnetic stimulation in the last three months * experienced hallucinations or delusions

Keywords: bipolar depression escitalopram mood stabilizer atypical antipsychotic
study of safety and efficacy of multiple doses of cfz533 in two distinct populations of patients with sjogren's syndrome

Conditions: Sjögren Syndrome

Summary: this study will evaluate safety, efficacy, pharmacokinetics (pk) and pharmacodynamics (pd) of multiple doses of cfz533 (iscalimab) in patients with sjögren's syndrome.

this is a double-blind, randomized, placebo-controlled, multicenter study of cfz533 in 2 distinct populations (cohorts) of patients with sjögren's syndrome: 1) moderate-to-severe disease (systemic and symptomatic involvement) and; 2) low systemic involvement but high symptom burden. the study includes up to 6 weeks screening period, 48 weeks of treatment (divided into treatment periods of 24 weeks each) and 12 weeks follow up. study treatment will be administered as bi-weekly subcutaneous injections.

Eligibility criteria:
inclusion criteria: * signed informed consent * male or female patient ≥ 18 years of age * classification of sjögren's syndrome according to acr/eular 2016 criteria (shiboski et al 2017) * seropositive for anti-ro/ssa antibodies * stimulated whole salivary flow rate of ≥ 0.1 ml/min inclusion criteria specific for cohort 1: * essdai ≥ 5 within the 8 predefined organ domains * esspri score of ≥5 inclusion criteria specific for cohort 2: * essdai \< 5 within 8 domains scored for inclusion criterion for cohort 1 * esspri fatigue subscore ≥ 5 or esspri dryness subscore ≥ 5 exclusion criteria: * sjögren's syndrome overlap syndromes where another autoimmune rheumatic disease constitutes the principle illness * use of other investigational drugs * prior use of b cell depleting therapies, abatacept or any other immunosuppressants unless specifically allowed be the protocol. * use of steroids at dose \>10 mg/day. * uncontrolled ocular rosacea (affecting the eye adnexa), posterior blepharitis or meibomian gland disease (this criterion applies only to patients considered for cohort 2) * active viral, bacterial or other infections requiring systemic treatment * receipt of live/attenuated vaccine within a 2-month period prior to randomization. * chronic infection with hepatitis b (hbv) or hepatitis c (hcv). * evidence of active tuberculosis (tb) infection.

Keywords: sjögren fatigue dryness anti-cd40 cfz533 iscalimab twinss autoimmune
the effect of a charcoal deactivation pouch on opioid disposal after cesarean delivery

Conditions: Pain, Acute; Opioid Misuse; Obstetric Pain; Cesarean Section Complications

Summary: background: there is scarce literature investigating how patients dispose of unused opioid supplies after their cesarean postoperative pain has faded. the office of the surgeon general has identified research on the prevention of opioid use disorder area as well as research on the management of pain as a "surgeon general priority" that needs urgent investigation. hypothesis: at least 33% of postpartum women discharged home with an opioid prescription and a drug deactivation pouch will use the pouch to dispose of remaining opioids within 30 days of delivery. methods: this is a prospective single arm interventional pilot study.


Eligibility criteria:
inclusion criteria: * age 18+ at time of enrollment, per erm * delivered ≥26.0 weeks, per erm * status post low transverse cesarean delivery, per erm * physically located on labor \& delivery and is postpartum day #1 or #2 at time of enrollment, per erm * opioid prescription has been sent (per erm) or will be sent (per obstetric team). exclusion criteria: * positive urine toxicology anytime in pregnancy for non-prescription opioids, fentanyl, amphetamines, benzodiazepines, cannabinoids, lsd, or cocaine, per erm. * buprenorphine or methadone rx, per erm * patient preferred communication language not english, per erm * documented history, per erm: * cannabinoid use disorder * hypnotic use disorder * opioid use disorder * stimulant use disorder * fibromyalgia * sickle cell anemia * lumbar disc herniation * multiple sclerosis * trigeminal neuralgia * active cancer * complex regional pain syndrome * systemic lupus erythematosus * rheumatoid arthritis

Keywords: opioid disposal drug deactivation deterra
early virtual reality based home rehabilitation program after total hip arthroplasty

Conditions: Osteoarthritis, Hip

Summary: total hip replacement (thr) is one of the most common interventions in orthopedic surgery. rehabilitation is essential for maximizing the effectiveness of the surgery. tele-rehabilitation programs after orthopedic surgery have proven their effectiveness, validity and cost-efficacy. it seems of interest to test the potential advantages of early virtual reality based rehabilitation programs after total hip arthroplasty compared to standard care. the aim of the study is to evaluate the functional recovery following total hip arthroplasty and home telerehabilitation programs with a virtual reality based system.


Eligibility criteria:
inclusion criteria: * males and females from 50 to 70 years old * patients undergoing total hip arthroplasty with anterior minimally invasive surgery (amis) * body mass index ≤ 31 * schooling: lower secondary certificate * home internet connection * caregiver presence * domiciled in the conurbation of milan * written informed consent and consent to all phases of the study exclusion criteria: * congenital or post traumatic morphological abnormalities * presence of neurological conditions or cancer * presence of implanted devices subjected to electromagnetic interference * epilepsy * informed refusal * ongoing anticoagulant or immunosuppressive therapies before surgery * self reported pregnancy
evaluation of intraoperative lagophthalmos formula

Conditions: Ptosis, Eyelid

Summary: this is a prospective non-randomized study to evaluate the recent intraoperative lagophthalmos formula method for levator resection in determining postoperative eyelid height in congenital ptosis on egyptian children. included 20 eyelids from 17 egyptian children with congenital ptosis with levator function of 4mm or better, they underwent levator muscle resection guided by the recent intraoperative lagophthalmos formula

this is a prospective non-randomized study to evaluate the recent intraoperative lagophthalmos formula method for levator resection in determining postoperative eyelid height in congenital ptosis on egyptian children. the study included 20 eyelids of 17 egyptian children with congenital ptosis with levator function of 4mm or better, they underwent levator muscle resection guided by the recent intraoperative lagophthalmos formula. preoperative mrd 1 (margin-to-reflex distance 1) and levator function were measured, then intraoperative palpebral fissure opening was determined from formula: intraoperative lagophthalmos=9.08 - 0.48×preoperative mrd1 - 0.26× levator function. postoperative mrd 1 was measured after 1 day, 1week,1month, 3 months and 6 months .success was defined as postoperative mrd 1 ≥ 3 mm and difference between both eyelids height ≤ 1 mm at 6 months.

Eligibility criteria:
inclusion criteria: * simple congenital ptosis (any degree) with levator function of 4mm or more exclusion criteria: * levator function less than 4mm * a history of previous ptosis surgery * other accompanying congenital diseases, such as blepharophimosis, congenital fibrosis of the extraocular muscles, marcus gunn (jaw-winking) syndrome, double elevator palsy and congenital third nerve palsy

Keywords: congenital ptosis levator function mrd 1
the effect of carbetocin in decreasing intraoperative blood loss in abdominal myomectomy

Conditions: Abdominal Myomectomy

Summary: to investigate the effectiveness of carbetocin on reducing intraoperative blood loss during abdominal myomectomy


Eligibility criteria:
inclusion criteria: * • patients presenting for abdominal myomectomy with documented uterine fibroids on pelvic imaging * age ≥ 25 years and ≤ 50 years * pre-operative hemoglobin \>10 g/dl * ability to understand and the willingness to sign a written informed consent. * admissible medical/surgical history * five or less symptomatic uterine myomas * symptomatic stage 3 to 6 fibroids, according to figo staging exclusion criteria: * • post-menopausal women * patients with known bleeding/clotting disorders * patients with a history of gynecologic malignancy * hypertension. * cardiac and pulmonary diseases. * history of allergic reactions attributed to carbetocin
a social media intervention for risky drinking

Conditions: Drinking Behavior

Summary: this study is being completed to pilot prevention methods to promote wellness and reduce risky behaviors, including the use of substances such as alcohol and other drugs. this study will help the study team learn about ways of delivering this information that is both appealing and helpful to young adults.


Eligibility criteria:
inclusion criteria: * reside in the united states of america (usa) * be able to read english, view, and click on a social media advertisement. * self-reported past-month high-intensity drinking (hid) * regular snapchat use (at least 3 days/week). exclusion criteria: * if they fail identity verification based on: 1) internet protocol address (ip), 2) survey time completion, 3) repeat attempts, and 4) survey responses.
medication following bariatric surgery for type 2 diabetes mellitus

Conditions: Obesity; Type 2 Diabetes

Summary: the aim of this study is to investigate the continued usage of standard diabetes medications in the post operative period following bariatric surgery to determine whether this approach may improve long term diabetes control. at present, the standard of treatment in patients with type 2 diabetes is that all medication is stopped in the immediate postoperative period and only re-started if symptoms of diabetes re-emerge. although a large proportion of patients with diabetes will initially go in to remission, 80% experience relapse within five years. this study is needed to determine whether continuing medications is not only safe but will improve long term outcomes for patients with diabetes.


Eligibility criteria:
inclusion criteria: * eligible for bariatric surgery according to nice guidelines (gc 189) * type 2 diabetes mellitus * bmi \>30kg/m2 exclusion criteria: * recent hospitalisation in the past 30 days * recurrent hypoglycaemic episodes * recurrent hypotensive episodes * contraindications to bariatric surgery * previous bariatric surgery * current pregnancy * breastfeeding

Keywords: obesity type 2 diabetes
nanoparticles in nasal mucosa

Conditions: Chronic Hypertrophic Rhinosinusitis; Chronic Polypous Rhinosinusitis

Summary: the aim of this prospective study is to evaluate presence and quantity of nano-sized particles and interindividual differences in their distribution and elemental composition in human nasal mucosa obtained by mucotomy in patients diagnosed with chronic hypertrophic rhinosinusitis and to compare the obtained results with control specimen obtained from stillborn children.

samples of nasal mucosa are obtained by mucotomy in general anesthaesia from adult patients with chronic hypertrophic rhinosinusitis. each tissue sample is divided into 4 parts based on the distance from the nostrils and is dehydrated, thinly sliced and mounted on glass slides. then the tissue is analyzed with scanning electron microscopy (sem) and raman microspectroscopy (rms) to detect solid particles and characterize the morphology and compositions of the detected particles. a novel method of quantification of distribution of the particles has been designed and used to evaluate interindividual differences in distribution of the particles. history of employment is obtained from the patients and the data are compared with the findings in the tissue samples. the data acquired from the group of adult patients are compared with the results obtained from a group of control specimen of nasal mucosa harvested from stillborn children. it is presumed that no nano particles will be present in the stillborn children specimen since the mucosa was not exposed to airborne particles.

Eligibility criteria:
inclusion criteria: * chronic hypertrophic rhihosinusitis without polyposis non responsive to conservative treatment for at least six months * chronic hypertrophic rhihosinusitis with polyposis non responsive to conservative treatment for at least six months * age between 19 and 64 years of age * signed informed consent of the patient * stillborn children born after 28th week of gestation exclusion criteria: - non-signing of the informed consent

Keywords: nasal mucosa chronic hypertrophic rhinosinusitis mucotomy nanoparticles scanning electron microscopy raman microspectroscopy nasal polyposis
a study to demonstrate the bioequivalence of lacosamide tablets and dry syrup in healthy male japanese subjects

Conditions: Healthy Volunteers

Summary: this is a study designed to demonstrate the bioequivalence between lacosamide (lcm) tablet and dry syrup in healthy male japanese subjects


Eligibility criteria:
inclusion criteria: * subject is male and between 20 and 55 years of age (inclusive) * subject is of japanese descent as evidenced by appearance and verbal confirmation of familial heritage (a subject has all 4 japanese grandparents born in japan) * male subject confirms that when having sexual intercourse with a woman of childbearing potential, he will use condoms during the study and 1 week after the last dose of study drug exclusion criteria: * subject has any medical or psychiatric condition that, in the opinion of the investigator, could jeopardize or would compromise the subject's ability to participate in this study. * subject has clinically relevant out-of-range values for hematology, and serum chemistry, or urinalysis variables at the screening visit. * subject has any clinically significant abnormal physical examination (screening visit or day -1) and vital signs (screening visit). * subject has any clinically relevant ecg finding at the screening visit.

Keywords: lacosamide bioequivalence dry syrup