Kornimate/medical-research-clean huggingface dataset:
surgical pain after inguinal hernia repair (spaihr)

Conditions: Pain, Postoperative; Hernia, Inguinal

Summary: the purpose of this study is to test whether pregabalin added to the standard of care with dosing starting preoperatively and continuing for 1 week post surgery will decrease the intensity of acute post-operative pain following inguinal hernia repair.


Eligibility criteria:
inclusion criteria: * the subject will have elective ( the subject chooses, but does not have to undergo surgery for an emergency) open unilateral inguinal herniorraphy (hernia repair), using mesh lichtenstein surgery procedure and under general anesthesia and fentanyl or sufentanil/propofol initiation and sevoflurane or isoflurane maintenance plus local anesthetic infiltration at the conclusion of surgery. study surgery should be anticipated to be in the morning. * expected to be able to use and tolerate non-steroidal anti-inflammatory drugs (such as naproxen), tramadol, oxycodone, and acetaminophen/paracetamol for pain control after surgery. * the subject will be available for a visit within 72 hours of the day of surgery if not admitted the night before for baseline assessments before taking any study medication, and then to receive study medication prior to the day before surgery. * the subject is expected and agrees to remain at the hospital (or intermediate care facility) for a minimum of 3 hours following surgery. exclusion criteria: * subjects with non elective or emergency surgery (must have the surgery no matter what), or hernia with incarceration (the trapping of abdominal contents within the hernia itself). * subjects with hernia repair that is not a primary repair. the planned use of nerve block or spinal/epidural/paravertebral anesthesia or surgery is not planned with general anesthesia. * subjects that are not allowed to receive the anesthesia agents indicated per protocol and general anesthesia.

Keywords: postoperative pain chronic pain
responsiveness to clopidogrel and stent-related events in acute coronary syndromes (reclose 2 - acs)

Conditions: Acute Cardiac Syndrome; Stent Thrombosis; Platelet Function; Antiplatelet Therapy

Summary: the main objective of the project is to assess the long-term prognostic impact of residual platelet reactivity after optimal antiplatelet therapy in a large cohort of patients with acute coronary syndrome undergoing invasive strategy. follow-up length will be at least 24 months. the primary end-point of the study will be a composite of death, myocardial infarction, urgent target vessel revascularization, stent thrombosis or stroke.

this study is mainly based on a registry of 2000 consecutive patients with acute coronary syndrome who received invasive treatment and for whom platelet reactivity after clopidogrel treatment will be prospectively assessed. in the acute phase, blood samples for platelet reactivity assessment will be obtained 12 to 18 hours from 600 mg clopidogrel loading. platelet-rich plasma, obtained by centrifuging whole blood for 10 min at 200 g, was stimulated with 10 m adenosine 5'-diphosphate (adp) and residual aggregation will be assessed using a apact 4 light transmittance aggregometer. platelet aggregation (according to the born's method) will be evaluated considering the maximal percentage of platelet aggregation in response to stimulus. patients with platelet aggregation by 10 µmol adp ≥ 90th percentile of controls (70%) will be defined as non-responders. the assessment of platelet reactivity will be repeated at 6 months. the importance of concomitant aspirin resistance will be also evaluated in such of patients.

Eligibility criteria:
inclusion criteria: * acute coronary syndrome * invasive treatment exclusion criteria: * in-hospital death that was not due to stent thrombosis, * anticipated poor compliance to dual antipletelet treatment for at least 6 months, * premature discontinuation of clopidogrel therapy.

Keywords: acute cardiac syndrome stent thrombosis platelet function antiplatelet therapy
application of 3d printing guide plate in endoscopic spinal surgery

Conditions: Lumbar Disc Herniation; Lumbar Spinal Stenosis; Radicular Pain; Low Back Pain

Summary: application of 3d printing guide plate in endoscopic spinal surgery

this study applies 3d-printed customized guide plate in assisting the accurate puncture in endoscopic spinal surgeries, in patients with low back pain, lumbosacral radicular pain, abnormal sensation or muscle strength or reflex of lower extremity, cauda equina syndrome, etc. this technique can shorten reduce the intra-operative radiation, and do not affect the surgical outcome. this study involved diseases such as lumbar disc herniation, lumbar spinal stenosis, radiculopathy, disc degeneration, etc. endoscopic spinal surgeries are effective treatments for these disease. needle puncture is the key technology in endoscopic spinal surgeries. in the past when there were no customized guides, the surgeons would place the needle according to his/her previous experience under the guidance of c-arm fluoroscopy or ct. if the position of the needles is not satisfactory, repeated procedure will be performed. this would lead to an increase in the duration of surgery and intra-operative radiation, which is detrimental to both the surgeon and the patient. this problem could be well solved by applying the 3d printing guide plate. the key processes for the 3d printing guide plate procedure: the model of the spine or bone is established according to the patient's ct scan data to prepare the customized guide plate, then sterilize them for future use. the final position of needle is confirmed by c-arm fluoroscopy or ct or evoked pain.

Eligibility criteria:
inclusion criteria: 1. age ≥18 years old; 2. pain lasting ≥12 weeks; 3. the previous failure of conservative management such as physiotherapy, exercise therapy, or analgesic medications; 4. pain intensity≥4 out of 10 on the numerical rating scale (nrs); 5. availability of computed tomography/magnetic resonance imaging findings of pathology concordant with the side and level of their clinical features; 6. agree with endoscopic spinal surgeries. exclusion criteria: 1. patient refusal to participate in the study; 2. pregnant or nursing; 3. allergies to local anesthetics, contrast dyes or steroids; 4. significant anatomic deformity (either congenital or acquired) making it difficult to access the target as evidenced by computed tomography/magnetic resonance imaging; 5. patients with platelet dysfunction, bleeding disorder or continuing anticoagulant treatment; 6. systemic infection; 7. injection site infection; 8. unstable medical or psychiatric condition; 9. unable to tolerate the surgeries.

Keywords: endoscopic spinal surgeries 3d printing guide plate
cryoenergy or radiofrequency for pulmonary vein isolation

Conditions: Atrial Fibrillation

Summary: this is a prospective single-center randomized trial comparing the efficacy and safety of pv cryoablation with the arctic front® catheter versus the standard pv isolation using radiofrequency irrigated tip catheters. the efficacy of both strategies will be evaluated from a clinical point of view and from the detection and quantification of af episodes by means of the reveal xt® implantable loop recorder.

pulmonary vein (pv) isolation using a radiofrequency catheter is the most widespread technique for atrial fibrillation (af) ablation. these procedures are difficult and time-consuming, because they require precise catheter manipulation and multiple radiofrequency applications. thus, alternative techniques are being investigated to simplify the procedure. recently, a cryoenergy balloon catheter has been developed for pv isolation (arctic front®, cryocath technologies). when this catheter is deployed at the pv antrum, it can create a circumferential lesion around the pv ostium by delivering a single cryoenergy application. an implantable loop recorder for af detection has been made available (reveal xt®, medtronic). it may help taking clinical decisions regarding anticoagulant and antiarrhythmic therapy and, at the same time, it may be a powerful tool to evaluate the efficacy of different therapeutic strategies. this is a prospective single-center randomized trial comparing the efficacy and safety of pv cryoablation with the arctic front® catheter vs. the standard pv isolation using radiofrequency irrigated tip catheters. the efficacy of both strategies will be evaluated from a clinical point of view and from the detection and quantification of af episodes by means of the reveal xt® implantable loop recorder.

Eligibility criteria:
inclusion criteria: * symptomatic recurrent paroxysmal af (\>2 episodes in the last 6 months), and * refractory to one or more class i or iii antiarrhythmic drugs, and * pv anatomy consisting of 4 single pv, with the long diameter of the right superior pv ostium ≤ 20 mm. exclusion criteria: * age: \ 75 year-old * prior af ablation * pregnancy * concomitant acute illness * hyperthyroidism * moderate to severe valvular heart disease * prior cardiac surgery * left atrium \> 50 mm (anteroposterior diameter, parasternal long-axis view) * intracardiac thrombus * contraindications for anticoagulant therapy * inability to be followed in our center for at least 1 year

Keywords: atrial fibrillation catheter ablation cryoenergy implantable loop recorder pulmonary vein
comparative effects of gong's mobilization with gradually graded exercise therapy

Conditions: Chronic Pain; Neck Pain; Shoulder Syndrome

Summary: this project was a randomized clinical trial conducted to find out the comparative effects of gong's mobilization with gradually graded exercise therapy for chronic neck pain among the users of electronic gadgets so that we can have best treatment option for patients.

the study design was a randomized clinical trial. for the study data was collected from sports and spine professionals. sample size was calculated with the help of epitool calculator. the study will be completed in 6 months duration. neck disability index (ndi), numeric pain rating scale (nprs) for pain intensity and universal goniometers for measuring (roms) and forward head posture (fhp) were assessed before and 4 weeks after the treatment through the craniovertebral angle (cva) measured from a digitized, lateral-view photograph of each subject. all the subjects were selected using non probability convenient sampling technique. the subjects were randomly assigned to one of the following two groups: gong's mobilization (group 1) or gradually graded exercise therapy (group 2).this study was conducted in accordance with the rules of the declaration of helsinki. written informed consent were taken from all the subjects before participating in this trial. spss 25 was used for data entry and analysis.

Eligibility criteria:
inclusion criteria:• subjects with an age range of 15 to 65 years having chronic neck pain for more than 3 months and subjects having a baseline ndi score of atleast 20% (10 points). - exclusion criteria: * • cervical stenosis * history of traumatic injury * previous surgery related to cervical spine * hypermobility * cancer * inflammatory rheumatologic diseases * severe psychological disorders * being pregnant and * intervention including exercise or physical therapy in the last 3 months.

Keywords: gong's mobilization gradually graded exercise therapy
stroke treatment associate to rehabilitation therapy and transcranial dc stimulation

Conditions: Stroke; Cerebrovascular Disorders; Cerebral Infarction

Summary: the purpose of this study is to determine whether active stimulation of the affected hemisphere will be more effective than simulated current in treatment of stroke

stroke is defined as an acute neurological dysfunction of vascular origin, with subtle development of clinical signs of cerebral function disturbs, lasting more than 24h. the traditional therapy includes drugs and physical rehabilitation, without systematization, with complicates its replication. the transcranial direct current (dc) stimulation might promote an increase in the motor function of the hands, when compared with placebo stimulation. in fact, some clinical trials point positive effects of transcranial dc stimulation (tdcs) as a post-stroke intervention, however, in general, they only include patients in the chronic stage, with cerebral damage in different areas and diverse disabilities, most being assisted by non-standardized physical therapy treatments. tdcs combined with a standardized physiotherapy program, noted as constraint-induced movement therapy (cimt), could be able to modulate the cortical excitability and promote better functional recovery. however, no relate of longitudinal studies assessing patients in the acute stage submitted to tdcs and physiotherapy for more than 6 months have been found. studies like this would help us elucidate the action mechanisms of this treatment in the early stages of stroke. with this in mind, start - tdcs, a phase ii/iii clinical trial, will be developed to assess the therapeutic effects of the tdcs in early stage enrolling 40 post-stroke patients. they will be allocated in 2 groups at random to receive active tdcs or sham, associate to cimt. the protocol will be applied in a daily basis for 10 consecutive working days (2 weeks), after that, the patients will be followed for 1 month. by the end of the study, the participants that receive tdcs and show better clinical condition will be invited to participate in bimonthly stimulation for 12 months, as part of a longitudinal study regarding tdcs for stroke. an increase in the clinical condition will be considered as a final score higher than 10 points in the barthel index, our primary outcome, when compared with baseline, before the treatment protocol.

Eligibility criteria:
inclusion criteria: * ischaemic acute stroke * informed consent exclusion criteria: * 25 ≤ national institute of health stroke scale ≤ 32 * rankim ≥ 5 * mini mental state examination ≤ 24 * tdcs criteria: use of modulators of the central nervous system drugs; patients with implanted metallic or electronic devices; pacemaker; seizures; pregnancy;any other condition that might limit or interfere in the sensorimotor system cimt criteria: inability to actively execute the movements of wrist flexion, metacarpophalangeal and interphalangeal active extension of 10º and wrist extension of 20º

Keywords: rehabilitation direct current stimulation acute stroke
the effect of remote ischemic preconditioning in living donor hepatectomy

Conditions: Tissue Donors; Liver Transplantation; Ischemia Reperfusion Injury

Summary: liver transplantation is the gold standard treatment for patients with end-stage liver disease. despite its outstanding success, liver transplantation still entails certain complications including ischemia-reperfusion injury. remote ischemic preconditioning is a novel and simple therapeutic method to lessen the harmful effects of ischemia-reperfusion injury, however, the majority of remote ischemic preconditioning studies on hepatic ischemia-reperfusion injury have been animal studies. therefore, our aim was to assess the effects of remote ischemic preconditioning on postoperative liver function in living donor hepatectomy.

liver transplantation(lt) is the gold standard treatment for patients with end-stage liver disease. in light of advancements in surgical techniques, immunosuppressive agents, and perioperative critical care, the overall 3-year survival of patients undergoing lt has exceeded 80%. despite its outstanding success, lt still entails certain complications including ischemia-reperfusion injury (iri). iri occurs when the blood supply to an organ or tissue is temporarily cut-off and then restored, and it is well-known as an underlying cause of primary non-function, biliary complications, and eventual graft loss after lt. despite many attempts to ameliorate hepatic iri, no definitive therapies have been established. in addition, the mechanisms of iri remain largely unclear. remote ischemic preconditioning (ripc) is a novel and simple therapeutic method to lessen the harmful effects of iri. ripc indicate that brief episodes of ischemia with intermittent reperfusion are introduced at a remote site, leading to systemic protection against subsequent insults as evinced on kidney, heart, liver, and other tissues. while ripc has been shown to reduce hepatic iri in several small animal studies, the beneficial effects of ripc in hepatic iri have been inconsistent. by far, the majority of ripc studies on hepatic iri have been animal studies; hence, there are limitations relating to the lack of human clinical trials. therefore, our aim was to assess the effects of ripc on postoperative liver function in living donor hepatectomy.

Eligibility criteria:
inclusion criteria: * donors who plan to have living right hepatectomy for liver transplantation. * age : between 18 to 60 years. exclusion criteria: * donors who plan to donate left lobe * donors who plan to have laparoscopic right hepatectomy * donors who cannot proceed remote ischemic preconditioning

Keywords: remote ischemic preconditioning liver donors
plasma concentrations of calcium, phosphate, fgf23, klotho, 25 (oh) d3 and 1,25 (oh) 2d3 from patients who wants to have children

Conditions: Infertility, Female

Summary: 1,25-dihydroxy-vitamin d3 (1,25 (oh) 2d3) or calcitriol regulates plasma calcium and phosphate concentrations in the blood by stimulating intestinal absorption and renal reabsorption of calcium and phosphate. 1.25 (oh) 2d3 is formed by the renal 1α25oh vitamin d-hydroxylase (cyp27b1) and inactivated by the renal 25-hydroxy vitamin d-24-hydroxylase (cyp24). unpublished studies in mice revealed an inhibitory effect of 1.25 (oh) 2d3 on embryo implanation. an excess of 1.25 (oh) 2d3 could therefore lead to female infertility. the excess of 1.25 (oh) 2d3 could result from uncritical vitamin d intake with insufficient negative feedback by fgf23 / klotho. the aim of the study is to identify patients with an excess of 1.25 (oh) 2d3.

the physiological institute of the university tübinge has succeeded in preventing vascular calcification in klotho-deficient mice by inhibiting osteogenic signal transduction. the animals reach an almost normal life span despite increased 1.25 (oh) 2d3, ca2 + and phosphate plasma concentrations. the male animals are again fertilized, but not the female animals. however, if the plasma concentrations of 1.25 (oh) 2d3 are normalized by administration of a vitamin-poor diet, the female animals are fertilized within two weeks. further investigations revealed an inhibitory effect of 1.25 (oh) 2d3 on the implantation of the embryo. in the meantime the 1,25 (oh) 2d3-dependent signal transduction could be revealed, which prevents the implantation of the embryo. the vitamin d receptor and the elements of signal transduction are also expressed in the human endometrium. it is therefore possible that increased 1.25 (oh) 2d3 plasma concentrations also prevent embryo implantation in humans.

Eligibility criteria:
inclusion criteria: - exclusion criteria: * known systemic diseases, e.g. autoimmune disease, scleroderma, malignant disease
sex differences in postoperative sleep quality and inflammation

Conditions: Sex Differences; Postoperative Sleep Quality; Postoperative Pain; Inflammation Function

Summary: video-assisted thoracoscopic surgery(vats) is among the most common and disabling persistent pain and inflammation conditions, with increasing prevalence in the developed world, and affects women to a greater degree than men. and sleep disruption also remains a challenging problem in surgical settings. postoperative sleep disturbances (posd) are defined as changes in the sleep structure and quality of patients during the early stages after surgery, which are manifested as significantly shortened rapid eye movement (rem) sleep, prolonged awake time, and sleep fragmentation. long-term posd may increase the risk of postoperative delirium or cognitive dysfunction and delay recovery, thereby worsening the patient's physical condition. the aim of the study was to investigate the effect of sex differences on postoperative pain, inflammation and sleep quality among patients who have undergone video-assisted thoracoscopic surgery under general anesthesia.


Eligibility criteria:
inclusion criteria: * 18-80 years old * asa i-iii * under general anesthesia exclusion criteria: * patients with central nervous system and mental diseases; * patients with preoperative sleep disturbances; * patients with a history of sedative, analgesic, or antidepression drug use; * patients with sleep apnea or moderate and severe obstructive sleep apnea-hypopnea syndrome;

Keywords: sex differences postoperative sleep quality postoperative pain inflammation function
texting to reduce alcohol misuse pilot trial

Conditions: Alcohol Consumption

Summary: the primary aims of this project are to determine the feasibility and acceptability of recruiting and retaining young adult binge drinkers online and using text messaging to provide weekly goal support (gs) or weekly gs + coaching for context-specific peer support (ccps) on alcohol consumption. the secondary aims will determine effect sizes for gs and gs+ccps groups relative to controls on alcohol consumption at 6- and 12-weeks to inform design of an adequately-powered trial.


Eligibility criteria:
inclusion criteria: * english reader * owns a mobile phone with sms * hazardous alcohol consumption as measured by: "how many times in the past year have you had x or more drinks in a day?", where x is 5 for men and 4 for women, and a response of 1 or greater is considered at-risk * at least in contemplative stage of change for reducing alcohol consumption exclusion criteria: * currently enrolled or past enrollment in a 4-year college * pregnant or pregnancy plans in the next 3-months * current or planned treatment for alcohol or substance use disorder in next 3-months

Keywords: young adults binge drinking text message