Kornimate/medical-research-clean huggingface dataset:
comparing pain relief between two methods of freezing injections in children having their appendix removed

Conditions: Laparoscopic Appendectomy

Summary: laparoscopic appendectomies are the most common emergency surgeries performed in children. despite being considered minimally invasive surgeries, they can result in substantial postoperative pain and 2 of 3 patients require postoperative opioids. increased postoperative pain can delay recovery, increase hospital admission time, lead to chronic pain, and cause patient distress. this study aims to reduce postoperative pain in this population by comparing the recovery outcomes associated with the administration of (1) an rsb with coadministration of iv dexamethasone as an la adjunct (rsb+dex group) prior to the incision with (2) la infiltration alone by the surgeon (la group).


Eligibility criteria:
inclusion criteria: * age 4-18 years old * diagnosed with acute appendicitis. * undergoing a laparoscopic appendectomy exclusion criteria: * perforated/complicated appendicitis diagnosis * previous abdominal surgery * allergy to bupivacaine or dexamethasone * severe developmental delay preventing patients from using pain scales or adequately communicating pain * patients with type 1 or 2 diabetes mellitus * patients with steroid dependence

Keywords: rectus sheath block dexamethasone laparoscopic appendectomy analgesia anesthesia local anesthetic
smart flex stent system for the treatment long femoropopliteal artery lesions

Conditions: Peripheral Arterial Disease

Summary: this study aims to evaluate the effectiveness and safety of the smart flex stent system in treating long femoropopliteal native lesions.

one hundred twenty patients with lesion lengths longer than 15 cm will be included. patients will be invited for a follow-up visit at 1, 6, 12, and 24-month post-procedure. the primary effectiveness endpoint of the study is the primary patency at 12 months. the primary safety endpoint is freedom of major adverse events (maes) at 12 months. secondary endpoints include acute procedure success rate; primary patency rate at 1, 6, and 24 months; freedom from tlr at 1-, 6-, 12, and 24-month follow-up; primary and secondary sustained clinical improvements at 1-, 6-, 12- and 24-month follow-up; freedom of maes at 1-, 6-,12- and 24- month follow-up; change of quality of life at 1-, 6-,12- and 24- month follow-up.

Eligibility criteria:
inclusion criteria: 1. the patient presented a score from 2 to 5 following rutherford classification 2. the patient is willing to comply with specified follow-up evaluations at the specified times 3. the patient is \>18 years old 4. patient understands the nature of the procedure and provides written informed consent before enrolment in the study 5. the patient has a projected life expectancy of at least 24 months 6. before enrolment, the guidewire has crossed the target lesion 7. target lesion length ≧150mm by angiographic estimation 8. stenosis \> 50% or occlusion in the femoropopliteal artery 9. there is angiographic evidence of patent distal popliteal artery and at least one distal runoff to the foot exclusion criteria: 1. previous bypass surgery or stenting in the target vessel 2. patients who exhibit acute intraluminal thrombus at the target lesion vessel 3. patients with known hypersensitivity or contraindication to any of the following medications: nitinol-titanium, antiplatelet therapy, anticoagulants, or thrombolytics therapy 4. pregnant women or female patients with potential childbearing 5. use of thrombectomy, atherectomy, or laser devices during the procedure 6. untreated inflow disease of the ipsilateral pelvic arteries (more than 50% stenosis or occlusion 7. the patient is currently participating in another investigational drug or device study that has not reached the primary endpoint. 8. significant renal dysfunction (serum creatinine \>2.0mg/dl) 9. patient with known allergy to contrast media

Keywords: femoropopliteal lesions patency
possible ameliorating effect of n- acetylcysteine (nac) on type-ii diabetes induced nephropathy

Conditions: Diabetic Kidney Disease; Diabetes Mellitus, Type 2; Diabetic Nephropathies

Summary: the study is focused on the possible improving effect of n-acetylcysteine on nephropathy of type-2 diabetic patients. study design: prospective clinical based study. the aim of this work is to study the effect of n-acetylcysteine (nac) on proteinuria and on the serum level of lipoprotein a (lpa) in diabetes induced nephropathy in type-2 diabetic patients.

this study will be carried on 60 participants with type 2 diabetes with age over 20 years. participants will be classified into two groups: 1. group i (interventional): treated with (nac) dose of 1200 mg/day for two months in conjunction with conventional treatment. 2. group ii (non-interventional): control group receive conventional treatment. all patients will undergo the following: 1. full medical history will be taken. 2. laboratory investigations as follows: blood samples will be collected for analysis after overnight fasting at the beginning and after 2 months of the study for determination of: 1. total cholesterol (t-chol). 2. plasma triglycerides (tg). 3. high density lipoprotein cholesterol (hdl-c). 4. low density lipoprotein cholesterol (ldl-c). 5. fasting blood sugar. 6. blood urea nitrogen (bun). 7. serum creatinine (scr). 8. urine analysis. 9. glycated hemoglobin (hba1c). 10. lipoprotein (a). in addition, blood pressure will be measured for 24 hr.

Eligibility criteria:
inclusion criteria: 1. confirmed diagnosis of diabetes mellitus. 2. age over 20 years. 3. patients with proteinuria ≥ 30 mg /dl. exclusion criteria: 1. patients on lipid lowering medications. 2. cigarette smokers. 3. presence of liver and heart diseases.

Keywords: n-acetyl cysteine lipoprotein a triglycerides total cholesterol glycated haemoglobin fasting blood sugar serum creatinine blood urea nitrogen urine analysis high density lipoprotein low density lipoprotein
diagnosis and allergen identification of perioperative anaphylaxis

Conditions: Perioperative/Postoperative Complications; Anaphylaxis; Tryptase; Allergens; Skin Testing

Summary: perioperative anaphylaxis may lead to fatal respiratory and/or circulatory events, yet both clinical diagnosis and management are challenging. serum tryptase is an indicator that can provide important retrospective diagnostic value for anaphylaxis. another key point in perioperative anaphylaxis management is to identify the allergens, and thus avoid re-exposure during later perioperative management. skin testing is an important way to identify allergens.

perioperative anaphylaxis are rare, but may be fatal. the combined use of anesthetic drugs and other medications, and the additional effects of surgical procedures, make the diagnosis and differential diagnosis rather complicated. subsequent allergy investigations and allergen identification are often difficult. the change of tryptase levels is an important biomarker in differentiating anaphylaxis from other causes. it is recommended that, in case of any suspicion of perioperative anaphylaxis, serum samples for tryptase detection should be collected as soon as possible after the onset of symptoms and then repeated 24 h later. skin testing including skin prick tests (spt) and intradermal tests (idt) is universally used in identifying allergens. skin testing will be performed 4-6 weeks after the onset of perioperative anaphylaxis. this prospective cohort study is designed to clarify the rate of perioperative anaphylaxis with testing serum tryptase level and to identify the underlying allergens by conducting skin testing in surgical patients with suspected perioperative anaphylaxis.

Eligibility criteria:
inclusion criteria: * aged 2 years or over; * suspected anaphylaxis in the operating rooms, or history of suspected anaphylaxis in the operating room. exclusion criteria: * refuse to participate; * other conditions that are considered unsuitable for study participation.

Keywords: perioperative/postoperative complications anaphylaxis tryptase allergens skin testing
contrast ultrasound assessment of perfusion changes after peripheral artery revascularization

Conditions: Peripheral Artery Disease

Summary: this study represents an important step to validate the use of contrast-enhanced ultrasound (ceu) as a clinical research tool that can be used as a biologic readout of new therapies for peripheral artery disease (pad), and as a clinically-reasonable method for assessing impact of revascularization. the primary aim is to establish that ceu limb perfusion imaging can be used to accurately assess therapeutic improvements in tissue perfusion that are linked to symptom improvement.

the study will be performed in patients with known history of pad that are scheduled to undergo either surgical or percutaneous revascularization. limb rest-stress ceu perfusion imaging will be performed before and 3-4 weeks after revascularization. quantitative measurements of pre-revascularization perfusion, post-revascularization perfusion, and change in perfusion will be compared to symptom status (rutherford classification and pad \[criqui\] questionnaire) at each study point, and to data on time to onset of claudication on an upright treadmill exercise study (gardiner protocol). results of angiography will be scored and allow determination of the relationship between angiographic severity of disease and exercise perfusion.

Eligibility criteria:
inclusion criteria: 1. history of symptomatic pad 2. rutherford score \<6 3. age ≥18 y.o. 4. scheduled to undergo surgical or percutaneous revascularization exclusion criteria: 1. major medical illness affecting the limb other than pad (muscle disease, neuromuscular disease, blood diseases). 2. pregnant or lactating females (- hcg in women of child bearing age) 3. hypersensitivity to any ultrasound contrast agent 4. evidence right-to-left, bi-directional, or transient cardiac shunt; unexplained pulmonary hypertension (pa systolic pressure \>40 mm hg) or more than moderate reduction in left ventricular systolic function identified on screening echo. 5. allergy to eggs 6. inability to perform modest plantar flexion exercise

Keywords: peripheral artery disease contrast enhanced ultrasound
the efficacy and safety of dezocine pretreatment for pain relief in acne scar treatment of fractional co2 laser

Conditions: Acne Atrophica

Summary: the efficacy and safety of dezocine pretreatment for pain relief in acne scar treatment of fractional co2 laser


Eligibility criteria:
inclusion criteria: 1. age: 18-60 years old, regardless of gender; 2. clinical diagnosis of atrophic acne scars; 3. planning to undergo ultra-pulsed co2 lattice laser therapy; 4. the patient agrees to participate in this experiment and signs an informed consent form exclusion criteria: 1. those who take sedative drugs for a long time; 2. patients with sleep apnea syndrome, previous history of hypertension, and blood pressure greater than 160/100mmhg 3. people with severe heart and lung diseases, liver and kidney diseases, psychosis, pregnancy, and communication disorders; 4. persons who are known to be allergic to the main drug or any of the excipients in dezocine injection; 5. increased intracranial pressure or head injury; 6. acute and chronic alcoholism; 7. people with hypotension, hypothyroidism, acute episodes of asthma, and epilepsy -

Keywords: acne scar, dezocine, pain relief, fractional co2 laser
assessing patient comfort, anxiety, and satisfaction during cr comparing conventional drops with roc

Conditions: Cycloplegic Paralysis of Accommodation

Summary: this study aims to compare the efficacy of conventional cycloplegic agents, such as cyclopentolate, with rapid-onset cycloplegics, like a combination of tropicamide and phenylephrine, in reducing patient anxiety and discomfort during cycloplegic refraction. cycloplegic refraction is an essential procedure for diagnosing refractive errors, particularly in children, by temporarily paralyzing the ciliary muscle to inhibit accommodation. while cyclopentolate has a relatively quick onset, tropicamide is preferred due to its faster onset and shorter duration. despite its advantages, concerns about patient discomfort and anxiety during the procedure remain, especially in pediatric populations.

the study will involve participants aged 3-16 years, with no significant refractive error or ocular pathologies. patients will be randomly assigned to receive either cyclopentolate or tropicamide with phenylephrine. the primary outcomes include patient comfort, anxiety levels, satisfaction, and procedure time. discomfort and anxiety will be measured using questionnaires such as the visual analog scale for comfort and the state-trait anxiety inventory. the study will help determine if rapid-onset cycloplegic provide a better patient experience by reducing discomfort and anxiety. by evaluating these factors, the research seeks to improve clinical practices in optometry and ophthalmology, particularly in pediatric eye examinations.

Eligibility criteria:
inclusion criteria: * patients aged 10-20years. * both male and female * healthy participants with no abnormalities detected in anterior segment structures or fundus examination using slit-lamp biomicroscopy and a 90-diopter lens. * no significant refractive error (within the range of ±1 diopter in spherical equivalent). exclusion criteria: * history of severe allergic reactions or adverse effects to cycloplegic agents * severe anxiety, panic disorders, or other psychological conditions that may interfere with reporting the experience accurately. * uncontrolled systemic diseases (e.g., uncontrolled diabetes or cardiovascular conditions) that may impact the response to cycloplegic agents. * recent ocular surgery (e.g., lasik, cataract surgery) or eye trauma affecting refraction accuracy or comfort. * presence or history of any intraocular diseases, including glaucoma, uveitis, and retinal disorders. * systemic disorders such as hypertension, cardiovascular disease, or respiratory disease.
causes of visual loss in retinal disease

Conditions: Uveitis; Scleritis

Summary: this is a study of visual outcomes in retinal disease that seeks to identify the causes of visual loss. this data will be used to predict which patients are at risk of losing vision and how they can be better treated.

this is a study of visual outcomes in retinal disease. it is an observational study of patients who have been seen in the retinal clinic, and involves a retrospective casenotes analysis to identify patients who have suffered visual loss and the reason for that visual loss. these data will be analysed to enable the identification of factors that predict visual loss in patients who present earlier in the course of their disease.

Eligibility criteria:
inclusion criteria: * patients with a diagnosis of ocular inflammation * patients with at least 6 months of follow-up exclusion criteria: * patients without a diagnosis of ocular inflammation * patients with less than 6 months of follow-up

Keywords: uveitis scleritis
safety and immunogenicity of a cell culture-derived influenza vaccine in healthy adults and elderly

Conditions: Influenza

Summary: the present study aims to evaluate the safety and immunogenicity of the new influenza subunit vaccine produced in madin darby canine kidney (mdck) cells in healthy adult and elderly subjects.


Eligibility criteria:
inclusion criteria: 1. 18 to 60 years of age (first age group) or over 60 years of age (second age group) 2. mentally competent to understand the nature, the scope and the consequences of the study 3. able and willing to give written informed consent prior to study entry 4. available for all the visits scheduled in the study 5. residence in the study area 6. in good health as determined by: 1. medical history, 2. physical examination, 3. clinical judgment of the investigator. exclusion criteria: 1. unable or unwilling to give written informed consent to participate in the study 2. suffering from an acute infectious disease 3. any serious disease such as: 1. cancer (except for benign or localized skin cancer and non metastatic prostate cancer not currently treated with chemotherapy),_ 2. autoimmune disease (including rheumatoid arthritis), 3. advanced arteriosclerotic disease or complicated diabetes mellitus, 4. chronic obstructive pulmonary disease (copd) requiring oxygen therapy, 5. acute or progressive hepatic disease, 6. acute or progressive renal disease, 7. congestive heart failure 4. surgery planned during the study period 5. bleeding diathesis 6. history of hypersensitivity to any component of the study medication or chemically related substances, such as allergy to eggs or egg products 7. known or suspected impairment/alteration of immune function resulting from: 1. receipt of immunosuppressive therapy (any cortical steroid or cancer chemotherapy), 2. receipt of immunostimulants, 3. receipt of parenteral immunoglobulin preparation, blood products, and/or plasma derivatives within the past 3 months and for the full length of the study, 4. high risk for developing an immunocompromising disease within the past 6 months 8. history of drug or alcohol abuse 9. laboratory confirmed influenza disease in the past 6 months 10. received influenza vaccine within the past 6 months 11. received another vaccine or any investigational agent within the past 60 days, or planned vaccination within 3 weeks following the study vaccination 12. any acute respiratory disease or infections requiring systemic antibiotic or antiviral therapy (chronic antibiotic therapy for urinary tract prophylaxis was acceptable) or experienced fever ≥ 38°c within the past 3 days 13. pregnant women or women who refused to use a reliable contraceptive method throughout the study (180 days) 14. any condition which, in the opinion of the investigator, might have interfered with the evaluation of the study objectives.

Keywords: safety immunogenicity non-inferiority mdck cell culture-derived subunit influenza vaccine influenza prevention
characteristics of adult patients with recessive dystrophic epidermolysis bullosa

Conditions: Epidermolysis Bullosa Dystrophica

Summary: recessive dystrophic epidermolysis bullosa (rdeb) is a severe inherited blistering disease caused by the absence of type vii collagen. patients with rdeb develop large, severely painful blisters and open wounds from minor trauma to their skin. we are screening rdeb subjects to determine additional characteristics of patients who survive to adulthood.


Eligibility criteria:
inclusion criteria:1. clinical diagnosis of rdeb by local dermatologist. 2. 18 years of age or more and willing to give consent. exclusion criteria:1. medical instability limiting ability to travel to stanford university medical center.
treatment of prepubertal labial adhesions

Conditions: Prepubertal Labial Adhesions

Summary: first-line treatment for labial adhesions in prepubertal girls has been topical estrogen. this study aims to evaluate an alternative and less costly option of treatment with potentially less side effects. primary hypothesis: there will be a difference in complete resolution of labial adhesions with topical estrogen with lateral traction as compared to an emollient with lateral traction.

the etiology of labial adhesions is unclear but appears to be related to hypoestrogenism in combination with vulvar irritation. for many years, first-line treatment for labial adhesions in prepubertal girls has been topical estrogen. with the use of topical estrogen, 50% of labial adhesions resolve in 2 to 3 weeks and most labial adhesions resolve with 6 weeks of treatment. however, because topical estrogen is systemically absorbed, its use is associated with side effects such as breast budding, vulvar hyperpigmentation, vaginal bleeding. there is a high risk of recurrence of labial adhesions of up to 35% after treatment with topical estrogen. in addition, topical estrogen is costly. therefore, there continues to be controversy over the optimal treatment of labial adhesions in prepubertal girls. generally, for medical treatment of labial adhesions, topical estrogen is applied to the adhesion whist applying gentle lateral traction to promote separation of the labia. it is, therefore, plausible that the lateral traction applied to the adhesion site is what ultimately results in the separation of the labial fusion, while the use of estrogen improves healing after mechanical separation. this is a single site, prospective, randomized, double-blinded study evaluating the comparative effectiveness of topical estrogen with lateral traction versus topical emollient with lateral traction for the treatment of labial adhesions in prepubertal girls.

Eligibility criteria:
inclusion criteria: * prepubertal girls ages 3 months to 12 years with labial adhesions exclusion criteria: * presence of underlying dermatologic conditions such as lichen sclerosis, severe atopic dermatitis, psoriasis or vitiligo * presence of systemic conditions that can have vulvar manifestations such as crohn's disease and behçet disease * presence of disorders requiring immunosuppressant treatment * previous surgical separation of labial adhesions

Keywords: vulvar disease, adhesions, topical therapy labial adhesions prepubertal girls labial agglutination labial fusion
mast - magnesium for sickle cell acute crisis in children

Conditions: Anemia, Sickle Cell

Summary: the purpose of this study is to determine if intravenous magnesium sulfate treatment is effective in reducing the length of stay and pain in children with sickle cell disease suffering an acute vaso-occlusive episode.

sickle cell disease is a group of complex, chronic disorders characterized by hemolysis, acute vaso-occlusive episodes (crises), unpredictable acute complications that can be life-threatening, and the variable development of chronic organ damage. administration of magnesium sulfate has the potential to reduce hemolysis since it induces negatively charged chloride ions and water entry to the cell. to date only one non-randomized, non-blinded, single arm study with only 19 children evaluated the effect of magnesium on length of stay in the hospital of children with sickle cell disease. in this randomized, double blind, two-arm placebo controlled study, children with sickle cell disease admitted for a vaso-occlusive crisis will receive intravenous magnesium sulfate or placebo every 8 hours during their stay in the hospital , along with pain management. we will measure length of stay (los), pain, adverse effects, and the total amount of narcotics required for pain control.

Eligibility criteria:
inclusion criteria: * known sickle cell disease * previous painful crisis resulting in an emergency department(ed) visit * current visit with a chief complaint of pain * age 4 years - 18 years * staff ed decides to admit to the hospital * staff ed decides to start an intravenous line exclusion criteria: * fever (\>38.5c) during the 24 hours prior to visit at triage * patients transfused within 90 days of study entry * patients with known renal disease * patients with known heart block or myocardial damage * patients who take a magnesium-containing medication or calcium channel blocker on a regular basis * patients who received anesthetics, cardiac glycosides and neuromuscular blockers during the acute illness in the last 24 hours * patients or parents unable to communicate in english * known pregnancy * known allergy to magnesium * admission to the icu * enrolment to the study in the last 30 days

Keywords: anemia, sickle cell magnesium sulfate pediatric