Kornimate/medical-research-clean huggingface dataset:
remifentanil vs fentanyl during cardiac surgery and chronic thoracic pain

Conditions: Chronic Pain; Sternotomy; Remifentanil; Fentanyl

Summary: this study will investigate the influence of intra-operative use of remifentanil versus fentanyl on the percentage of patients with chronic thoracic after cardiac surgery via sternotomy. secondary quantitative sensory testing is performed to determine thermal and electrical detection and pain threshold and the difference in pain variability scoring. postoperative pain scores, analgesic use, genetic variances and costs are measured.


Eligibility criteria:
inclusion criteria: * patients undergoing cardiac surgery via sternotomy (coronary artery bypass graft (cabg) and/or valve replacement) * patients admitted to the icu or pacu in the st. antonius hospital * patients between 18 and 85 years old * patients weighing between 45 and 140 kg * written informed consent exclusion criteria: * pregnancy/ breastfeeding * language barrier * history of drug abuse * neurologic condition such as peripheral neuropathy * known remifentanil, fentanyl, morphine or paracetamol allergy * body mass index (bmi) \> 35 kg/m2 * prior cardiac surgery (re-operations); * patients with chronic pain conditions.

Keywords: chronic thoracic pain remifentanil fentanyl sternotomy
citrate versus heparin for the lock of non-tunneled hemodialysis catheters in patients hospitalised in icu

Conditions: Patients With Acute Renal Insufficiency

Summary: after obtaining written informed consent and inclusion, patients will be randomised into 2 groups for the type of dialysis catheter lock: * the first group will have a citrate lock * the second group will have a heparin lock patients will be stratified according to the centre and type of renal replacement therapy (rrt) continuous or intermittent. the daily surveillance of patients will not be different from the usual surveillance of patients on renal replacement therapy. the hemodialysis catheters used will be specific renal replacement therapy catheters. the decision to withdraw the catheter will be made by the investigator and based on clinical criteria (complications related to the catheter, termination of renal replacement therapy...)


Eligibility criteria:
inclusion criteria: * patients aged \> 18 years * requiring rrt for acute renal insufficiency * for which a 1st non-tunneled catheter is placed * in the jugular or femoral position * after written informed consent has been obtained from the patient, a member of the family or a person of trust exclusion criteria: * patient presenting active poorly controlled bleeding * known allergy to citrate * acute liver failure (prothrombin level \<30%) * thrombopenia \< 30 000/mm3 * known or suspected heparin-induced thrombopenia * known systemic bacterial infection at the time the catheter is placed * catheter in the subclavicular position * persons not affiliated to a national health insurance scheme * pregnant women * adults under guardianship
treatment of refractory status epilepticus

Conditions: Status Epilepticus

Summary: the purpose of this study is to determine whether propofol or barbiturates should be preferred in the treatment of status epilepticus (continuous seizure activity) refractory to 2 standard antiepileptic agents.

refractory status epilepticus (se) develops in 31%-44% of patients with se, with a mortality of 16%-23%. coma induction is advocated for its management. propofol and barbiturates are the most used agents, but no comparative study has been performed. in consideration of the uncertainty regarding the relative effectiveness, despite several retrospective data, a prospective investigation is needed. the objective is to assess the effectiveness (se control, adverse events) of a first course of propofol versus barbiturates in the treatment of refractory se, in adults with refractory se not due to cerebral anoxia. comparison: coma induction with standardized doses of propofol or barbiturates titrated towards burst-suppression on eeg, then assessment of the proportion of patients achieving a control of se.

Eligibility criteria:
inclusion criteria: * patients with refractory status epilepticus not due to cerebral anoxia, needing coma induction for clinical management. exclusion criteria: * age \< 16 years old. * known pregnancy. * cerebral anoxia as se etiology. * epilepsia partialis continua (simple partial se). * known intolerance to the study drugs. * known mitochondrial disorder, hyperlipidemia, or significant rhabdomyolysis.

Keywords: refractory status epilepticus, coma-induction, treatment, propofol, barbiturates, efficacy, safety.
a randomised multi-centre study to compare the short-term outcomes of minimally invasive and conventional surgery in primary total hip replacement

Conditions: Osteoarthritis(Primary)

Summary: the purpose of this study is to compare the short-term outcomes of two surgical techniques, minimally invasive and conventional, when used in the treatment of patients with hip joint disease requiring a total hip replacement. patients who enter the study will be randomly allocated to undergo surgery using the minimally invasive or conventional surgical technique and will be evaluated at regular intervals following hip surgery using patient, clinical and x-ray assessments with a focus on short term rehabilitation.


Eligibility criteria:
inclusion criteria: i) male or female subjects, aged between 18 and 75 years inclusive. ii) subjects who are able to give voluntary, written informed consent to participate in this investigation and from whom consent has been obtained. iii) subjects who in the opinion of the investigator, are able to understand this investigation, co-operate with the investigational procedures and are willing to return to the hospital for all the required post-operative follow-ups. iv) subjects with a primary diagnosis of osteoarthritis. v) subjects considered suitable for a primary total hip arthroplasty and are considered suitable for a minimally invasive surgical procedure. exclusion criteria: i) subjects who, in the opinion of the investigator, have an existing condition that would compromise their participation and follow-up in this study, or extend their time to discharge beyond that required for their hip replacement surgery. ii) women who are pregnant. iii) subjects who are known drug or alcohol abusers or with psychological disorders that could effect follow-up care or treatment outcomes. iv) subjects who have participated in a clinical study with an investigational product in the last 6 month(s). v) subjects who are currently involved in any injury litigation claims. vi) subjects with a body mass index (bmi) \> 30. vii) subjects with a malunion, arthrodesis or severe dysplasia with superior femoral head migration. viii) subjects requiring a simultaneous bilateral total hip arthroplasty. ix) subjects undergoing the second stage of a staged bilateral who are less than 9 months post-arthroplasty

Keywords: hip surgical technique
the impact of medication belief on adherence to infliximab in patients with crohn's disease

Conditions: Inflammatory Bowel Diseases

Summary: the ifx adherence to cd in china was not high. medicine concerns may be predictive factor of adherence. by enhancing knowledge and relieving medicine concerns, we may increase patients' adherence to ifx.

crohn's disease (cd) is an incurable chronic disease that requires long-term treatment. as an anti-tumor necrosis factor (tnf) agent, infliximab (ifx) is widely used in the treatment of crohn's disease, while the adherence is not high. the purpose of this study was to investigate the adherence to ifx among cd patients in china and evaluate the association between medication belief and ifx adherence.

Eligibility criteria:
inclusion criteria: * patients with a confirmed diagnosis of cd; were treated with infliximab for at least 12 weeks; were informed consent. exclusion criteria: * the exclusion criteria were received treatment from mental health professionals due to any mental or cognitive impairment; suffered from other serious diseases, such as heart, brain, lung, liver and kidney dysfunction; severe infection, anemia, cachexia or other serious complications were found.

Keywords: crohn's disease; adherence; medication concern; infliximab
characterization of lipoprotein composition and function in pediatric psoriasis before and after treatment

Conditions: Psoriasis

Summary: this study will assess differences in inflammatory proteins, lipoprotein composition, cholesterol efflux and hdl-proteome in moderate-to-severe pediatric psoriasis who at baseline begin systemically administered therapy vs: a) healthy controls; and b) patients with milder psoriasis.


Eligibility criteria:
inclusion criteria: * children ages 6-17 years of all races/ethnicities with plaque and/or extensive guttate psoriasis for at least 6 months and on topical or systemic therapy * patients in the systemic group can be starting a medication for the first time or transitioning from another systemic if unresponsive and on that previous treatment for ≤ 3 months. * patients may concurrently have psoriatic arthritis if initiation of a systemic medication is warranted by skin severity. * children ages 6-17 years of all races/ethnicities with acne being treated with isotretinoin * children ages 6-17 years of all races/ethnicities without plaque or guttate psoriasis and history of severe acne or treatment with isotretinoin as controls. exclusion criteria: * patients less than 6 years of age or 18 years and older * patients with congenital heart disease, prior cardiac catheterizations/surgeries, or on cardiac medications in the past two years other than for hypertension (eg, calcium channel-blockers, beta-blockers and vasotropic medications). * patients who have other systemic inflammatory diseases (including atopic dermatitis, severe acne, inflammatory bowel disease, juvenile idiopathic arthritis, connective tissue diseases and/or other autoimmune diseases). * patients who have active infection or malignancy or have suffered from infection requiring oral or parenteral antibiotic in past 2 weeks. * patients and parents/caregivers unable to give written informed consent.
e. coli 83972 induced asymptomatic bacteriuria (abu) in patients with recurrent urinary tract infections (uti)

Conditions: Urinary Tract Infection

Summary: this study tests the following hypothesis: does induced asymptomatic bacteriuria (e. coli 83972) protect against symptomatic urinary tract infections in individuals with bladder emptying dysfunctions and prone to recurrent infection episodes? the study is performed using a double-blind randomized study protocol with a cross-over, with re-inoculations being patient-blinded (phase 1). after patients have fulfilled the cross-over, those who have had bacteriuria or placebo-periods \< 12 months will be subjected to additional patient blinded inoculations (phase 2). during the entire study (phase 1+2) the study-team and the patients are unaware of urine culture results.


Eligibility criteria:
inclusion criteria: * recurrent uti * bladder emptying dysfunction * optimal conservative treatment incl. clean intermittent catheterization * capable of "self reporting of uti episodes" exclusion criteria: * malignant disease * immunosuppression * recurrent pyelonephritis * abnormalities within upper urinary tract, including renal stones and poor kidney function

Keywords: report of urinary tract infection episode
evaluating risk factors and biomarkers for adaptation and resilience to spaceflight

Conditions: Resilience; Mood; Performance; Stress, Psychological

Summary: this study assesses differences in biological and behavioral domains that relate to individual adaptation and resiliency to an isolated, confined and controlled environment, and evaluates the effect of confinement, work, monotony, and social and physical isolation on stress resiliency and well-being.

the goal of this study is to obtain novel information that will be used to help identify individuals who are resilient to the stressors of prolonged human spaceflight, thereby encouraging the successful completion of exploration missions and the preservation of health over the life of an astronaut. this study leverages the national institute of mental health (nimh) research domain criteria (rdoc) heuristic framework to conduct experimental studies to identify biological domains (molecular, circuitry, physiology) and behavioral domains that relate to individual adaptation and resiliency (as well as behavioral vulnerability) in spaceflight-relevant confined environments. this study focuses specifically on differences among participants in their tolerance of and adaptability to simulated conditions of spaceflight such as confinement, work, monotony, and social/physical isolation that impact behavioral health and performance.

Eligibility criteria:
inclusion criteria: * age between 30 and 55 years * a master's degree (or its equivalency in work experience) in science, technology, engineering and math (stem) or military service * free of psychological/psychiatric conditions that preclude participation * bmi \< 35 * ability to read/write english exclusion criteria: * history of neurological, psychiatric, or other medical condition that excludes participation * current mania or psychosis * current depression * current poor resiliency * alcohol or drug abuse in the past year based upon history and urine toxicology screen. * current smoker/tobacco user. * acute, chronic, or debilitating medical conditions, major axis i psychiatric illness, epilepsy, or thyroid disease based * cardiovascular, neurological, gastrointestinal, or musculoskeletal problems that exclude participation * for mri testing any of the following conditions may exclude subjects from participation in the present experiment: tinnitus; sensorineural hearing loss \> 30 decibels; pace maker or internal defibrillator; metallic implants (e.g. orthopedic plates after bone fractures, joint replacements, surgical staples or clips, artificial heart valves, stents, cava filters); metallic splinters (e.g. after an accident or due to war injury); non-removable dental brace; tattoo (some tattoo inks contain metallic particles); permanent make-up; intrauterine contraceptive device; cochlear implant (implanted hearing device); medication pump; acupuncture needle; other foreign bodies/objects which are non-removable; pregnancy (or its possibility); previous brain and/or heart surgery; and fear of tight spaces.
chemotherapy combination with local radiotherapy and rhgm-csf for oligometastatic stage iv nsclc patients

Conditions: Carcinoma, Non-Small-Cell Lung

Summary: the purpose of this study is to determine whether chemotherapy combination with local radiotherapy and rhgm-csf is safe, effective in the treatment of oligometastatic stage iv nsclc patients.

the purpose of this study is to determine whether chemotherapy combination with local radiotherapy and recombined human granulocyte-macrophage colony stimulating factor(rhgm-csf) is safe, effective in the treatment of oligometastatic stage iv nsclc patients who were pr or sd after first-line chemotherapy，and to observe the abscopal effect, whether the scheme can improve pfs and os.

Eligibility criteria:
inclusion criteria: 1. stage iv nsclc patients without clear driving genes who were pr or sd after standard first-line chemotherapy; 2. patients who were oligometastasis evaluated by pet-ct or other examinations after first-line chemotherapy. eligible patients should have 2 to 5 distant metastases (at least 2 metastases were suitable for low fractionated radiotherapy). at least one distant measurable lesion outside the radiation sites. 3. age varied from 18 to 75 years old. 4. ecog performance status 0-2. 5. expected lifespan ≥3 months. 6. absolute neutrophil count (anc) ≥1.5×109/l, platelets ≥100×109/l, hemoglobin ≥90 g/l. 7. able to understand and give written informed consent and comply with study procedures. exclusion criteria 1. allergy of rhgm-csf and its accessories. 2. disease of systemic immune or immune disorders. 3. histology confirmed small cell carcinoma or other malignant compositions in the cancer tissue. 4. patients with thrombotic disease or platelets ≥600×109/l 5. cancer history within 5 years apart from nsclc before enrollment. 6. tumor related immunotherapy within 4 weeks, including but not limited to immune cell therapy, tumor vaccine therapy, immune checkpoint therapy, and other immunomodulators (such as thymosin, lentinan) except for rhgm-csf. 7. the abnormality of kidney , heart or lung functions（serum creatinine, cr\>177mol/l; serum ast or alt more than 2 times above normal limits; total bilirubin, tbil\>34mol/l）. 8. hiv virus, hepatitis c virus or t lymphocyte virus (type1 or type 2) infection and active hepatitis or other uncontrolled infections. 9. women in pregnancy or lactation. 10. others who do not meet the inclusion criteria.
promoting effective recovery from labor urinary incontinence (perl)

Conditions: Urinary Incontinence; Pelvic Organ Prolapse; Perinatal Laceration; Second Stage Labor

Summary: the purpose of this study is to determine whether pushing during labor that is controlled by the woman results in less birth-related injury and less postpartum urinary incontinence (ui).

birth related urinary incontinence (ui) is a predictor of ui in older women. ways to protect the continence mechanism during delivery may diminish a woman's risk of ui later in life. we propose to study the functional anatomy of the pelvic floor as it relates to ui in women who are having their first baby. we hypothesize non-directed, spontaneous pushing is a protective strategy in decreasing the risk of immediate and long term ui. longitudinal comparisons of pelvic floor characteristics will be taken at 35 week gestation and 6 weeks, 6 months, and 12 months postpartum. study participants will be seen first at 20 weeks gestation for documentation of baseline levels of pelvic floor function, specifically voluntary and involuntary muscle strength, urinary continence status, and urethral support. they will be randomly assigned into non-directed, spontaneous (experimental) and directed, sustained pushing (control) groups. alterations that may occur in urethral support before and after birth will be described through non-invasive urethral ultrasound.

Eligibility criteria:
inclusion criteria: women giving birth for the first time who are: 1. age 18 years or older 2. less than 20 weeks gestation 3. expected vaginal birth without use of epidural analgesia 4. plan to reside in southeast michigan for one year following the birth of the infant. exclusion criteria: 1. history of genito-urinary or neuro-muscular pathology 2. previous pregnancy carried beyond 20 weeks gestation.

Keywords: pelvic floor muscle training self-directed pushing antenatal perineal massage
evaluation of hemodynamics and amount of blood flowing through the kidneys during liver transplant by measuring some physiological substances in blood and urines

Conditions: Hypovolemia During Liver Transplantation; Renal Hypoperfusion During Liver Transplantation

Summary: the purpose of this study is to verify any existing relationship between urinary parameters (such as excretion of sodium, chlorine, urinary partial co2 pressure \[puco2\]) and general volemic indicators (such as picco, scvo2, o2 delivery) during liver transplant.


Eligibility criteria:
inclusion criteria: * surgery for liver transplantation * age 18-75 * asa class i-iii exclusion criteria: * age above 75 or under 18 * asa class iv * pre-existing renal failure * pregnant patients * patients unable to give written consent

Keywords: hypovolemia renal hypoperfusion liver transplantation sodium chloride puco2 scvo2 picco o2-delivery hemodynamic indexes
serotonin control of impulsivity in tourette disorder

Conditions: Tourette Disorder

Summary: tourette disorder (td) is a neurodevelopmental disorder characterized by motor and vocal tics. it is often associated with multiple psychiatric comorbidities involving a high degree of impulsivity such as obsessive-compulsive disorders (ocd), attention-deficit hyperactivity disorders (adhd), and intermittent explosive disorders (ied). although a substantial body of clinical studies have emphasized the role of the dopamine system in motor symptoms, little is known about how the serotonergic (5-ht) system modulate both cognitive and affective abilities in td. several lines of evidence suggest that different 5-ht receptor subtypes may constitute a crucial factor in the development and maintenance of different symptoms. because abnormal 5-ht2a receptor bindings have been reported in patients with td and aripiprazole (drug of first choice) is a 5-ht2a antagonist, we hypothesize that 5-ht2a receptors may play an important role in regulating psychiatric symptoms in td such as those characterized by impulsive behaviors. to investigate the involvement of 5-ht2a receptors in td, we propose to perform a multimodal imaging study with 20 adult patients (on and off treatment). neuroimaging data will be collected with a hybrid system that simultaneously combines the positron emission tomography (pet) and the functional magnetic resonance imaging (fmri). a highly selective pet radiotracer (\[18f\]-altanserin) will map 5-ht2a receptor bindings in the whole brain, while fmri will provide detail information regarding the altered brain activities.


Eligibility criteria:
* inclusion criteria \* : * male or female * diagnosed with a tourette disorder following the dsm-5 * age between 18-65 years * member of a social security scheme in france * freely-given informed consent to participate to this study (written form) * with a current treatment by aripiprazole already scheduled * with tics compatible with tep/fmri exams * having (for women only) effective contraception throughout participation in the study. exclusion criteria \* : * male or female * a serious not controlled psychiatric comorbidity * a serious, evolving or debilitating pathology with a potential influence on the study * drug-taking with serotonergic effects (e.g., amphetamine, cocaine, mdma, ssris, mianserin) * contraindication for fmri and pet (e.g., pacemaker, ferromagnetic implant, claustrophobia) * women breastfeeding * protected or restricted person (administratively or in judicial terms) * participants to another study with radiations or radiotracers since less of one year, participants to a concomitant study * do not speak french

Keywords: tourette serotonin impulsivity neuroimaging
airflow perturbation device (apd) for the evaluation of pulmonary and sleep disorders

Conditions: Airway Obstruction

Summary: in a prospective, observational study the investigators compared resistance values measured using the airway perturbation device (apd) to impulse oscillometry and spirometry. the investigators also created reference equations for normal apd resistance ranges using the data from clinically normal volunteers.


Eligibility criteria:
inclusion criteria: * male and female subjects \> 18 years * referred for pfts and/or psg at wrnmmc * all races and ethnicities will be included * pregnant women will be included exclusion criteria: * \< 18 years of age * if mental status is questionable, the patient will be excluded at the discretion of the consenting provider * unable/unwilling to follow the directions necessary for apd use