Kornimate/medical-research-clean huggingface dataset:
evaluation of post-pacu pain management in pediatric surgery

Conditions: Pain

Summary: this study aims to assess the differences in overall pain severity, pain management, and satisfaction during recovery period between two groups of children who either receive or do not receive additional education related to expectation and management of postoperative pain.

with the increased frequency and popularity of pediatric ambulatory surgery, there is a greater need for evaluation of the postoperative pain experience after discharge from the hospital. pain is one of the most significant factors affecting the postoperative experience in adults, and also be true in the pediatric population. control of postoperative pain in children after discharge from the hospital poses particular challenges due to dependence on parental or caretaker ability to properly evaluate the child's pain, their understanding of appropriate dosing of pain medications, and their willingness to administer enough medications until sufficient relief is achieved. the investigators aim to assess the differences in reported pain between groups who receive additional face-to-face education versus the current standard of care at a major us teaching hospital. the study will assess pain management after surgery using parental reports and questionnaires to assess their child's pain at multiple time points during the study. additionally, this study will also assess baseline behavioral attributes of children and will compare behavioral changes at 24-48 hours, 7-10 days, and 2-4 weeks postoperatively as these behavior changes may also affect overall postoperative experience. this study is divided into phase i and phase ii. phase i is the initial assessment of the investigators' institution's pain management in healthy pediatric patients undergoing ambulatory surgical procedures. phase ii consists of randomized trial which includes a randomized intervention group and control group. the group selected randomly for intervention will receive additional teaching regarding what to expect in terms of postoperative pain and how to properly identify pain in children.

Eligibility criteria:
inclusion criteria: * patients ages 1-6 years undergoing ambulatory surgical procedures. * patients with an asa status of i or ii spending 23 hours or less recovering in the pacu and discharged home. exclusion criteria: * patients with an asa status of iii or iv. * patients admitted as inpatients or transferred to the picu or inpatient for recovery, and any conditions that may affect pain expression or sensation.

Keywords: postoperative experience postoperative behavioral changes maladaptive behavioral changes
a dose escalation study of bradanicline in refractory chronic cough

Conditions: Chronic Cough

Summary: this is a randomized, double-blind, placebo-controlled, crossover, dose escalation study of bradanicline in subjects with chronic cough

this study will have two 21-day treatment periods separated by a 14-day washout period. there will be a 14-day follow-up period.

Eligibility criteria:
inclusion criteria: * chest radiograph or computed tomography (ct) scan of the thorax within the last 1 year not demonstrating any abnormality considered to be significantly contributing to the refractory chronic cough * diagnosis of refractory chronic cough or unexplained cough for at least one year * women of child-bearing potential who use 2 forms of acceptable birth control method * male subjects and their partners of child-bearing potential who use 2 methods of acceptable birth control * has provided written informed consent exclusion criteria: * current smoker (cigarettes or e-cigarettes) or has given up smoking within the past 12 months * currently taking an ace-inhibitor or requiring treatment with an ace-inhibitor during the study or within 12 weeks prior to the baseline visit * has an upper or lower respiratory tract infection or recent significant change in pulmonary status within 4 weeks of the baseline visit * has a history of cystic fibrosis * has a history of malignancy within 5 years prior to the baseline visit * has active hepatitis infection * has a history of human immunodeficiency virus (hiv) infection * has a positive test for any drug of abuse * has a history of hypersensitivity to bradanicline or any of its components
a study to evaluate the safety, tolerability, and immunogenicity of v116 when administered concomitantly with influenza vaccine in adults 50 years of age or older (v116-005, stride-5)

Conditions: Pneumonia, Pneumococcal

Summary: this a study of v116 in adults ≥50 years of age who concomitantly received influenza vaccine. the primary objectives of this study are to evaluate the safety, tolerability, and immunogenicity of v116 when administered concomitantly with quadrivalent influenza vaccine (qiv) compared with v116 administered sequentially with qiv. the primary hypotheses state that immune responses to v116 and to qiv are non-inferior when administered concomitantly as compared with sequential administration as measured by serotype-specific opsonophagocytic activity (opa) for v116 and hemagglutination inhibition (hai) geometric mean titers (gmts) for qiv, at 30 days postvaccination.


Eligibility criteria:
inclusion criteria: * any underlying chronic conditions were assessed to be in stable condition per the investigator's judgment * females: not pregnant or a breast feeding and not a woman of childbearing potential (wocbp) or a wocbp agrees to use contraception or remain abstinent exclusion criteria: * history of ipd or other culture-positive pneumococcal disease * known or suspected impairment of immunological function * receipt of systemic corticosteroids or immunosuppressive therapy * received any pneumococcal vaccine \<12 months prior to enrollment * prior administration of pcv15 or pcv20 * received any influenza vaccine \<6 months prior to enrollment
role of tryptase levels in patients with stable coronary artery disease.

Conditions: Chronic Coronary Syndrome

Summary: the aim of this study is to measure the levels of serum tryptase and correlate them with the severity of coronary artery disease in study population. in addition, it will evaluate the usability of tryptase levels as a prognostic biomarker for future cardiovascular events.

coronary artery disease (cad) is the leading cause of death worldwide based on who' s latest review in 2019 with cad being responsible for the 16% of them. the main feature of coronary artery disease is the accumulation of atherosclerotic plaque in the epicardial arteries whether obstructive or non-obstructive. cad is further subclassified into chronic coronary syndrome (ccs) and acute coronary syndrome (acs). patients with ccs experience long and stable periods of myocardial ischemia. however, in the case of a plaque rapture these patients can turn into acs patients. the objective of this study is to predict that sudden shifting of patients from ccs to acs by associating the role of inflammation and its factors with cardiovascular events. in particular, it focuses on mast cell (mc) tryptase which provokes plaque instability in patients with ccs. mast cells needs to be activated to release tryptase and their activation mechanism seems to be the bridging point between tryptase and coronary artery disease. previous studies have shown that ige levels, which is the most potent activator of mc, are found high in hyperlipidemic patients. in addition, oxidized ldl (ox-ldl) is another mc activator. in reference to the fact that there might be a correlation between tryptase and coronary plaque instability in patients with chronic coronary syndrome, the investigator propose an interventional study for the role of tryptase as a prognostic biomarker in patients with ccs by studying a large population of greek subjects with ccs. the study will be conducted on 2 patient population: 1. patients without coronary artery disease (estimated stenosis \<70%) - control group 2. patients with coronary artery disease (estimated stenosis \>70%) - cad group

Eligibility criteria:
inclusion criteria: * male and female subjects aged 18 - 85 years old. * clinical symptoms of angina which are classified based on the canadian cardiovascular score (ccs score) * positive spect scan for myocardial ischemia exclusion criteria: * acute coronary syndrome 4 weeks before the coronary catheterization * percutaneous coronary angioplasty * coronary artery bypass graft * active symptoms of allergy (asthma, urticaria) * mastocytosis * hypereosinophilia * autoimmune disease * cancer * kidney failure * myelodysplastic syndrome * denial of signing informed consent

Keywords: chronic coronary syndrome tryptase biomarker mast cell activation plaque instability prognosis mace stable coronary artery disease
early spontaneous breathing in acute respiratory distress syndrome

Conditions: Acute Respiratory Distress Syndrome

Summary: the care of acute respiratory distress syndrome (ards) has been significantly improved by learning from experimental and physiological research works and by a series of randomized controlled trials. the mortality of this syndrome remains however high. numerous experimental and clinical works demonstrated that a ventilatory mode authorizing the patient to make, from the acute phase, spontaneous breathing cycles superimposed on assistance delivered by the ventilator (bipap-aprv mode) allowed to improve gas exchanges and hemodynamic tolerance of the ventilation while reducing the need for sedative drugs. this ventilatory mode could also reduce the risk of diaphragmatic dysfunction induced by ventilation. consequently, our hypothesis is that this ventilatory mode could allow a reduction of mortality in ards patients. the aim of this multicenter, prospective, randomized, controlled, open study is to compare the effects of two ventilatory strategies on the mortality of ards patients and placed under mechanical ventilation.


Eligibility criteria:
inclusion criteria: * within 1 week of a known clinical insult or new or worsening respiratory symptoms * intubation and mechanical ventilation * bilateral opacities - not fully explained by effusions, lobar/lung collapse, or nodules lung * report pao2 / fio2 ≤ 200 mmhg with a pep of at least 5 cmh2o * respiratory failure not fully explained by cardiac failure or fluid overload * criteria 1, 2 and 3 presents jointly for less than 48 hours * consent to participate obtained either from the patient himself or from a relative. exclusion criteria: * age \< 18 years * pregnancy * predictable duration of the mechanical ventilation on endotracheal tube lower than 48 hours * patient being in period of exclusion further to the participation in another biomedical study * intracranial hypertension (suspected or confirmed) * known or suspected copd * chronic respiratory failure treated by long-term oxygen and / or long-term respiratory support * morbid obesity defined as weight greater than 1 kg / cm * sickle cell disease * marrow recent transplant, post-chemotherapy aplasia * widened burns (\> 30% body surface area) * severe hepatic cirrhosis (child-pugh c) * pneumothorax (drained or not) * treatment with extracorporeal support (ecmo) * decision of active therapeutic limitation * unavailability of the model of respirator that must be used in the study * failure to obtain a consent by persons authorized to do so. * patient under law protection. * person non-beneficiary of a social security system

Keywords: acute respiratory distress syndrome aprv ventilatory mode spontaneous breathing intensive care unit
interest of the dermabrasion by laser erbium in the treatment of the vitiligo

Conditions: Vitiligo

Summary: the treatment of vitiligo remains disappointing especially in some localization such as bony prominences and extremities. the association of uvb and topical steroids has been proven to be synergistic but the results are still insufficient in those difficult to treat areas. promising results have been shown with the combination of laser assisted dermabrasion, topical 5fu and uvb. the investigators hypothesize that the dermabrasion of vitiligo skin followed by topical steroids should potentialized the effect of uvb and be superior to topical steroids and uvb without dermabrasion. the main objective of this study is to evaluate the usefulness of laser assisted dermabrasion combined to topical steroids and uvb phototherapy in difficult to treat areas. patients with symmetrical non segmental vitiligo will be included in this prospective randomized monocentrer study. the investigators calculated the number of patients needed at 25. the side that will receive the dermabrasion will be centrally randomized and the opposite side will serve as control. then on both side class 3 topical steroids will be applied daily 3 weeks on 4 for 12 weeks. uvb phototherapy will be performed twice weekly also for 12 weeks. the evaluation will be performed by two independent physician blinded to the treatment of standardized photos before and 1 month after the end of the treatment. the criteria of success will be at least 75% of repigmentation.


Eligibility criteria:
inclusion criteria: * age between 18 at 85 * not segmental vitiligo of clinical diagnosis located on bony projections or of ends * two symmetrical plates of vitiligo of more than 4 cm ² exclusion criteria: * pregnant women or breastfeeding. * vitiligo lesions on face and neck * personal history of skin cancer * photosensitize drugs * personal history of photodermatosis * personal history of keloids * concomitant treatment that could have an action on vitiligo (such as tacrolimus or pimecrolimus).
efficacy and safety of ingenol mebutate gel for actinic keratosis applied on large area on face, scalp or chest

Conditions: Actinic Keratosis

Summary: the objective of the trial is to investigate efficacy and safety of ingenol mebutate gel for actinic keratosis applied to large treatment areas once daily for three consecutive days on face, scalp or chest.


Eligibility criteria:
inclusion criteria: subjects with 5 to 20 clinically typical, visible and discrete, actinic keratosis (aks) non-hyperkeratotic and non-hypertrophic aks within a selected treatment area of sun-damaged skin on either: * the full face * the full balding scalp * a contiguous area of approximately 250 cm2 on the chest exclusion criteria: * location of the treatment area (full face, full balding scalp or chest) within 5 cm of an incompletely healed wound or within 5 cm of a suspected basal cell carcinoma (bcc) or squamous cell carcinoma (scc). * previously assigned treatment in this clinical trial or previously participated in a clinical trial in the leo clinical programme on ingenol mebutate gel for larger treatment areas. * treatment with ingenol mebutate gel in the selected treatment area within the last 12 months. * lesions in the treatment area that have: atypical clinical appearance (e.g. cutaneous horn) and/or, recalcitrant disease (e.g., did not respond to cryotherapy on two previous occasions).
evaluation of the role of brain natriuretic peptide in acute coronary syndrome .

Conditions: Acute Coronary Syndromes

Summary: the measurements of the natriuretic peptide are useful and beneficial for risk stratification irrespective of the cause during admission time or during hospital stay course. the aim of the study is to assessment of the role of brain natriuretic peptide in diagnosis of acute coronary syndrome . evaluation of the relation of brain natriuretic peptide to the severity and occurrence of complications in acute coronary syndrome .

ischemic heart disease (ihd) is regarded as one of the important leading causes of disability and death across the globe. acute coronary syndrome (acs) applies to a variety of events reporting ischemia, ranging from stable angina without myocardial necrosis to st -segment elevation myocardial infarction (stemi). the need for prevention and detection of coronary vascular disease as early as possible by using newer and more cost effective tools is suggested . for risk stratification in patients with acs, serial ecg monitoring and cardiac biomarkers measurement are needed as part of the diagnostic workup. b-type natriuretic peptide is synthesized as a high molecular weight precursor pro-brain natriuretic peptide (bnp) which is cleaved to release bnp and the amino-terminal fragment, n-terminal pro (nt-pro) bnp. both peptides are released from the cardiac ventricles in response to the increased wall stress and hence its levels may indicate ventricular strain bnp is believed to have its role as natriuretic hormone and vasodilation. among other effects are inhibition of the renin angiotensin-aldosterone system(raas), and sympathetic nervous system. after an ischemic occurrence, bnp levels peak in 14 to 40 hours .

Eligibility criteria:
inclusion criteria: * patients with acute coronary syndrome. exclusion criteria: * patients with previous mi * eection fraction (ef) less than 30% * patients having cardiomyopathy * patients having renal, liver, malignant, infectious, or inflammatory diseases .

Keywords: brain natriuretic peptide
building resilience in caregivers of trauma survivors

Conditions: Caregiver Burnout

Summary: the purpose of the study is to examine the role of demographics, pre-existing anxiety, depression, and substance use on caregiver depression anxiety, and substance use following a critical injury to a loved one, evaluate the factors that mediate the effectiveness of traditional psychotherapy using problem solving therapy to reduce depression, anxiety, and substance use and to evaluate the factors that mediate the effectiveness of providing an icu diary and instruction on that diary to reduce depression, anxiety, and substance use.


Eligibility criteria:
inclusion criteria: * must anticipate serving in a caregiver role after the patient is discharged (a. must be either a family member or close friend of a patient who has been admitted to the trauma/critical care service icu b. must anticipate spending time with the patient in a caregiver or other supportive role (e.g., emotional, social, financial) after the patient is discharged * caregiver and patient must report english as a primary language * patient and caregiver must be able to provide informed consent * caregiver must be able to provide at least two forms of contact information * trauma patient directly admitted to the icu (primary cause of admission is trauma, injury must include trauma to the head/brain or polytrauma, admitted directly to the hospital, patient admission of at least 48 hours, patient is currently admitted to the icu, patient is expected to survive more than 96 hours at 48 hours after admission, patient has an abbreviated injury score greater than 3 (severe, critical, maximum), fluent in english) * trauma patient must be able to communicate verbally exclusion * does not anticipate serving in a caregiver role after the patient is discharged * caregiver is not a close friend or family member of the patient who has been admitted to the icu * caregiver does not expect to serve in a supportive role to the patient * caregiver does not meet inclusion criteria as stated above * patient is not currently admitted to the icu and or is not expected to remain in the icu for 48 hours * patient is not expected to survive more than 96 hours * patient is not expected to require assistance prior to discharge * patient is not between 17 and 65 years of age

Keywords: ptsd depression substance use
acute effects of two neoprene knee sleeves

Conditions: Knee Osteoarthristis

Summary: this study aimed to evaluate the immediate effects of two different types of elastic neoprene knee sleeves on balance and pain in patients with knee osteoarthritis (koa). one knee sleeve was a standard elastic neoprene sleeve, while the other had four metal supports for additional stability. in this randomized controlled study, 60 patients (50 females, 10 males) diagnosed with koa were divided into two groups: group 1: wore a standard elastic neoprene knee sleeve group 2: wore a neoprene knee sleeve with four metal supports each participant underwent clinical assessments before and after wearing the knee sleeve. the following tests were used: balance assessments: berg balance scale (bbs): measures overall balance ability. timed up and go (tug) test: evaluates mobility and fall risk. functional reach test (frt): assesses stability by measuring how far a person can reach forward. fall index (tetrax® posturography): provides an objective measure of fall risk. pain assessment: visual analog scale (vas): measures the intensity of pain. further long-term studies are necessary to determine whether these immediate benefits persist over time.

koa is a common joint disorder that leads to pain, stiffness, and impaired balance, increasing the risk of falls. knee sleeves are often used as supportive devices to provide stability and reduce pain. however, there is limited evidence on their effectiveness in improving balance and reducing pain in koa patients.

Eligibility criteria:
inclusion criteria: * radiographic knee osteoarthritis grade 2 (mild) or 3 (moderate) according to kellgren-lawrence scale, * knee muscle strength of 4 and above and those who voluntarily participated in the study * signed the informed consent form exclusion criteria: * patients with arthroscopy of the knee joint within the last 1 year, knee and/or hip replacement, * limitation of joint range of motion, * history of inflammatory rheumatic disease, * history of vestibular and cerebellar disease, * visual loss of less than 2/10 in both eyes, * history of diseases of the central and peripheral nervous system (parkinson's disease, stroke, ataxia, dementia, multiple sclerosis, peripheral neuropath etc.)

Keywords: balance, knee sleeve, osteoarthritis, posturography
prevalence of acute hepatic porphyria

Conditions: Acute Hepatic Porphyria

Summary: to determine the proportion of patients suffering from acute hepatic porphyria (ahp) from different hospital departments and referred to an internist referent for a suggestive clinical picture with a first negative etiological assessment.

in this context, this study aims to assess the prevalence of pha in a population of patients with a suggestive clinical picture. a better knowledge of the pathology will make it possible to better guide patients and prevent them from diagnostic wandering fraught with physical and psychological consequences. this is an observational, ambispective, transversal, multicenter study carried out in france. the goal is to recruit a cohort that will reflect current practice. 500 patients will be recruted.

Eligibility criteria:
inclusion criteria: * man or woman aged 18 to 60; * presenting severe abdominal pain, afebrile and diffuse over several days, evolving for less than 5 years; * with at least one of the following symptoms: * peripheral neurological symptoms: decreased driving force and pain in the limbs (roots of the thighs), etc. ; * central neurological symptoms: psychiatric (depression, anxiety, insomnia), disturbances of consciousness, etc. ; * autonomous neurological symptoms: tachycardia, nausea, vomiting, constipation, etc. * with a first negative etiological assessment requested by an emergency physician, gastroenterologist, gynecologist, neurologist, internist or another specialty, or with a diagnosis of acute hepatic porphyria less than 6 months; * patient able to understand the information related to the study and having indicated his non-objection to the collection of data concerning him; exclusion criteria: * patient with a diagnosis of acute hepatic porphyria for more than 6 months; * patient unfit to participate in the study, due to cognitive or linguistic difficulties; * protected patient (under legal protection, or deprived of liberty by judicial or administrative decision).