Kornimate/medical-research-clean huggingface dataset:
comparison of postoperative outcome after sevoflurane and propofol anaesthesia

Conditions: Postoperative Cognitive Dysfunction

Summary: as the investigators know, postoperative cognitive dysfunction (pocd) is a fairly well-documented clinical phenomenon, which affect patients' short-term and long-term outcome. most patients will receive general anesthesia and cardiopulmonary bypass (cpb) during cardiac valvular surgery. inhalation sevoflurane based and propofol based anesthesia are most commonly used strategy for general anesthesia. at present, it was unknown that which one is better in providing cerebral protection effect for patients undergoing cardiac valvular surgery with cpb. the current study aimed to explore the possible difference.

the investigators hypothesize that the incidence of postoperative cognitive dysfunction (pocd) is not different in patients received intravenous anesthetics propofol or sevoflurane for their cardiac valvular surgery. two groups of general anesthetics (propofol or sevoflurane) are used to explore the possible difference of the postoperative outcome and the incidence of pocd. after cardiac valvular surgery with cpb, patients' pocd tests at 7 days after the surgery, and postoperative delirium, etc., are evaluated by different questionnaires. also the blood sample of these patients are collected for detection of some stress hormones.

Eligibility criteria:
inclusion criteria: * patients who receive cardiac valvular surgery * 18 to 65 years * american society of anesthesiologists classification ⅱto ⅲ * education level higher than elementary school exclusion criteria: * patients are not expected to be alive for longer than 3 months. * mini-mental state examination (mmse) score ≤ 23. * current use of sedatives or antidepressant * history of dementia, psychiatric illness or any diseases of central nervous system. * accompanying liver or kidney function deficiency * history of some endocrine disease * alcoholism and drug dependence * patients previously included in this study or currently included in the other clinical study * patients who have second surgery during the study period * difficult to follow up or patients with poor compliance

Keywords: sevoflurane propofol cardiac valvular surgery cardiopulmonary bypass postoperative cognitive dysfunction
interventional study collecting quantitative and qualitative data about patient with non treated cancer

Conditions: Upper Aerodigestive Tract Cancer

Summary: this study aims to determine the impact of sociocognitive and emotional factors on the time of the initial consult

identify wich sociocognitive factors influence the delay to go to a doctor after the emergence of first symptoms

Eligibility criteria:
inclusion criteria: * age ≥ 18 years * oral cavity cancer, oropharynx cancer, hypopharynx cancer, larynx cancer * non treated cancer * patient informed of his diagnosis * speak fluent french * patient covered by health insurance * signed informed consent inclusion criteria for "interviewed " patients : * no speech troubles * patient consents being recorded exclusion criteria: * history of cancer * psychological history * patient under guardianship

Keywords: non treated cancer oral cavity oropharynx hypopharynx larynx first consultation
evaluation of whole body examination by mri integrating the "zero time eco" sequence (zte, pseudo-ct) for the detection of bone lesions in multiple myeloma: comparison with pet / ct and whole body scanner

Conditions: Multiple Myeloma; Bone Metastases

Summary: to assess the added value of magnetic resonance imaging (mri) of the skeleton compared to other validated techniques for the detection of bone lesions in patients with multiple myeloma.

the aim of our study is to offer patients benefiting from a diagnostic approach to myeloma by pet / ct, a whole body mri examination (mri-ce) comprising, in addition to the "classic bone marrow" sequences, a zte sequence (see below) . this study is being undertaken to compare and assess the complementarity of imaging techniques in the diagnostic management of this disease. the stages of the work will be: optimizing bone marrow exploration sequences by mri (f. lecouvet, n. michoux, gaetan duchêne). develop and validate a whole body-wide new mri sequence "zte" capable of detecting and quantifying disease-induced osteolysis in the skeleton. optimize the reconstruction of these images (deep learning software developed with the firm ge), training of the reconstruction of zte images by correlation with the scanner (f. lecouvet, n. michoux, gaetan duchêne). this approach is completely original, never having been evaluated: the zte sequence is a recent development, made available at cusl on the new research mri magnet. the addition of this sequence to the already major information provided by mri for the detection of the disease and the evaluation of its response (method of choice, see below) would constitute a major advance in establishing the diagnostic value of this technique. non-irradiating compared to other techniques (pet-ct, low dose scanner, etc.).

Eligibility criteria:
inclusion criteria: * patient with newly diagnosed multiple myeloma, for whom bone imaging is required for staging. * recurrent patient after intensive treatment (high dose chemotherapy, bone marrow transplant, etc.). * patient requiring a pet / ct considered as the technique of choice in these stages of the disease. exclusion criteria: * implanted material incompatible with mri. * severe claustrophobia. * pregnant women

Keywords: mri zero time echo
prognostic value of finger blood pressure in arteriovenous fistula care

Conditions: End Stage Renal Disease; End-Stage Kidney Disease; Dialysis Access Dysfunction

Summary: the goal of this trial is to investigate the prognostic value of monitoring finger blood pressures (fbps) in predicting the success of surgically created arteriovenous fistula (avf) for patients with end stage renal disease. the main questions it aims to answer is: - can fbps predict avf maturation? participants will undergo fbp measurements at pre-op, immediately post-op, 4 weeks and 6 weeks post-avf creation.


Eligibility criteria:
inclusion criteria: * participants has documented chronic kidney disease (ckd), determined by glomerular filtration rate (gfr) * participant is recommended for renal replacement therapy based on clinical assessment of renal function as well as ckd staging, as documented in clinical notes. * haemodialysis was chosen as the most appropriate renal replacement therapy * participant is able to consent to the creation of an avf in preparation for hemodialysis. * participant is able to adhere to follow-up assessments of avf maturation, if applicable. exclusion criteria: * subject had a previous avf and is now undergoing surgery for another avf creation * subject has amputation distal to avf * subject is pregnant or planning to conceive * participants is unable to consent
chest ultrasound versus chest x-ray with ct as gold standard at trauma patients

Conditions: Pneumothorax At Trauma Patients

Summary: the goal of this observational study is to learn about the predictive value of the chest ultrasound in detection of pneumothorax at chest trauma patients. the main question it aims to answer is: how does the performance of the chest ultrasound compare to chest x-ray in predicting pneumothorax in chest trauma patients in egypt? participants are patients with different ages isolated blunt chest trauma patients admitted to the emergency department during the study period.

chest trauma is a leading cause of morbidity and mortality, with timely and accurate diagnosis essential for effective treatment. while chest x-ray (cxr) has traditionally been the first-line imaging modality in emergency settings due to its availability and ease of use, it has limitations, particularly in detecting subtle or occult injuries like pneumothorax, haemothorax, rib fractures, and pulmonary contusions, especially in trauma patients positioned supine. overuse of cxr can also lead to increased costs, radiation exposure, and emergency department overcrowding. ultrasound has emerged as an alternative, with multiple studies showing that chest ultrasonography (cus) is highly sensitive and specific for detecting traumatic intrathoracic injuries, including pneumothorax. this systematic review and meta-analysis aimed to assess the diagnostic accuracy of cus compared to cxr. while ct scans remain the gold standard for diagnosing thoracic trauma due to their superior accuracy, they expose patients to significant radiation and should be used judiciously. although cxr is a fast and accessible option in emergencies, it may miss critical injuries, highlighting the importance of balancing diagnostic accuracy with patient safety and resource management in trauma care. the primary aim of this study is to evaluate and compare the diagnostic accuracy of chest ultrasonography (sonar) versus chest x-ray (cxr) in the detection of thoracic injuries in patients presenting with chest trauma, using computed tomography (ct) as the reference standard.

Eligibility criteria:
inclusion criteria: * patients with different ages. * both genders. * patients presenting with isolated blunt chest trauma. * patients who are hemodynamically stable and can undergo imaging studies (ultrasonography, cxr, and ct). * patients who provide informed consent (or proxy consent if the patient incapacitated). exclusion criteria: * hemodynamically unstable patients requiring immediate surgical intervention. * patients with contraindications to ct imaging (e.g., severe renal impairment without access to alternative contrast agents). * pregnant patients (due to radiation exposure from ct). * patients with previous thoracic surgery or pre-existing significant thoracic abnormalities that could interfere with imaging interpretation.
the safety and efficacy of zanubrutinib in refractory/relapsed autoimmune hemolytic anemia

Conditions: Refractory/Relapsed Autoimmune Hemolytic Anemia

Summary: the sample size of this study is calculated based on simon's two-stage design. the first stage of the study enrolled a cohort of 12 patients. if after 12 weeks at least 6 patients achieved a response, then enrollment was expanded to a total of 26 patients. the null hypothesis was unaccepted if more than 14 of 26 patients achieved the response. accounting for a 20% dropout rate, the estimated final sample size was 33 patients.


Eligibility criteria:
inclusion criteria: * age from 6 to 70 * diagnosis of coombs-negative aiha * diagnosis of warm aiha, mixed aiha or evans syndrome. * meets the criteria of relapsed / refractory aiha * ecog ≤ 3 * willing and able to comply with the requirements for this study and written informed consent. exclusion criteria: * diagnosis of any of the following diseases: cold agglutinin disease, cold agglutinin syndrome, mixed aiha, paroxysmal cold hemoglobinuria (pch). * diagnosis of active stage of connective tissue disease. * history of lymphoproliferative tumors or any other malignant. * diagnosis of other inherited or acquired hemolytic diseases. * secondary aiha caused by drugs or infection. * previously received organ or stem cell transplantation. * history of thrombosis or organ infarction. * received rituximab within 8 weeks before enrollment. * previously treated with btk inhibitor ≥ 2 weeks. * received low-molecular-weight heparin or warfarin within 1 week before enrollment and need to continue the drug treatment. * received cyp3a4 enzyme inhibitors or inducers within 1 week before enrollment and need to continue the drug treatment. * uncontrolled systemic fungal, bacterial, or viral infection (defined as ongoing signs/symptoms related to the infection without improvement despite appropriate antibiotics, antiviral therapy, and/or other treatment), known human immunodeficiency virus (hiv), known evidence of active infectious hepatitis b, and/or known evidence of active hepatitis c. * any severe and/or uncontrolled medical conditions: refractory hypertension, clinically significant cardiac diseases, renal diseases, liver diseases and metabolic diseases, etc. * history of mental illness. * participation in another clinical trial within 4 weeks before the start of this trial. * pregnant or breast-feeding patients. * patients considered ineligible for the study by the investigator for reasons other than the above.
efficacy of opioid-free anesthesia in reducing postoperative pain in chronic pain patients undergoing spinal surgery

Conditions: Chronic Pain; Anesthesia

Summary: the objective of this trial is to determine whether an opioid-free general anesthetic (ofa) technique utilizing ketamine, dexmedetomidine, and lidocaine infusions can help reduce postoperative pain in opiate-dependent chronic pain patients (cpps) undergoing spine surgery when compared with traditional opioid-containing techniques. it is expected that this ofa regimen will have a measurable reduction on postoperative opioid consumption and pain scores in cpps.


Eligibility criteria:
inclusion criteria: * chronic pain \> 6 months, opiate-using patients scheduled for thoracic or lumbar spinal surgery exclusion criteria: * pregnant or breastfeeding women, significant hepatic, renal or cardiac disease, allergy to any of the study drugs, inability to consent, respond to pain assessments or use the patient controlled analgesia device

Keywords: opioid-sparing
estimation of the dietary requirement for vitamin d in ethnic groups

Conditions: Vitamin D Deficiency; Immune Health; Muscle Function

Summary: the aim of this study is to perform a double-blind, randomised, dose-response trial of vitamin d3 supplementation in united kingdom (uk)-dwelling adults of white european, south asian, and black african/caribbean ethnicity to investigate the distribution of dietary intakes needed to maintain adequate vitamin d status in winter, as indicated by serum 25(oh)d concentrations at ranges of \>25 to 50 nmol/l. in addition, this study will investigate the effect of vitamin d3 supplementation on immune health, muscular strength, and overall health.

the aim of this study is to perform a double-blind, randomised, dose-response trial of vitamin d3 supplementation in united kingdom (uk)-dwelling adults of white european, south asian, and black african/caribbean ethnicity to investigate the distribution of dietary intakes needed to maintain adequate vitamin d status in winter, as indicated by serum 25(oh)d concentrations at ranges of \>25 to 50 nmol/l. in addition, this study will investigate the effect of vitamin d3 supplementation on immune health, muscular strength, and overall health. recruited participants will be randomised to take 400, 1000, or 2000 iu for 12 weeks. fasting blood samples collected at baseline and 12 weeks will measure biochemical markers of vitamin d status (serum 25(oh)d, calcium, parathyroid hormone, albumin), lipid profile, ferritin, micronutrient status, and immune and inflammatory biomarkers. muscular strength will be measured using sit-to-stand and grip strength tests. questionnaires, food diaries, and dosimeters will be used to gather data on lifestyle, physical activity, dietary intake, and sun exposure.

Eligibility criteria:
inclusion criteria: * british white european, black african/caribbean, or south asian (self-reported) * living in england for \>2 months * aged \>18 years * no significant health issues * english or urdu speaker exclusion criteria: * medical condition or history which might impact study measurements (e.g., ischaemic heart disease, type 1 and type 2 diabetes, thyroid disease, osteoporosis, haematological disease, malignancy) * medications known to affect vitamin d metabolism (i.e., hormone replacement therapy, anti-oestrogens treatment, antiepileptic drugs, and breast cancer treatment) * pregnant or planning pregnancy during the study period * regular use of sun beds * having a sun holiday one month prior to commencing study or plans for a sun holiday within the study period. a sun holiday is generally defined as a holiday in a sunny resort outside of the uk. the researchers will assess this on a case-by-case basis depending on the time of year and expected weather conditions * reported participation in another clinical trial occurring simultaneously * previous intolerance or allergic reaction to vitamin d
diagnostic accuracy comparison between telemedicine and face-to-face consultations in respiratory infection patients.

Conditions: Respiratory Tract Infections

Summary: this is a randomized study that sought to analyze the diagnostic accuracy of the telemedicine consultation of patients suspected of respiratory tract infections during covid-19 pandemic in comparison with the face-to-face evaluation at the emergency department.

unicentric, prospective and randomized study performed between september and november 2020 with adult patients who sought care at emergency department. the inclusion criterion was the exhibition of any tract respiratory symptom. patients older than 65 years, with chronic heart or lung diseases or immunosuppressed were excluded. eligible patients were randomized 1:1 for a brief telemedicine consultation, blinded to subsequent face-to-face evaluation or direct face-to-face evaluation.

Eligibility criteria:
inclusion criteria: * patients with at least one acute symptom compatible with rti (sore throat, nasal obstruction, coryza, new or growing cough, sputum, hoarseness, dyspnea) in presence or absence of symptoms related to the infection (fever ≥ 38oc, chills, sweating, myalgia) that motivated spontaneously face-to-face evaluation at the ed. exclusion criteria: * patients with diagnosis of chronic respiratory diseases (chronic obstructive pulmonary disease, asthma and interstitial lung disease) * patients with previous diagnosis of congestive heart failure, * patients with hiv / aids * patients with active cancer * patients with type i diabetes mellitus * patients in use of any immunosuppressant * patients with chronic cough * patiets that referral to emergency room after nursing triage.

Keywords: telemedicine respiratory tract infections emergency medical services referral and consultation covid-19
to evaluate the efficacy and safety of sr419 in patients with postherpetic neuralgia (phn)

Conditions: Postherpetic Neuralgia

Summary: this is a phase ii, international multicenter, double-blind, placebo-controlled, crossover study to assess the efficacy of sr419 in phn subjects.

the study will evaluate the efficacy and safety of sr419 in phn patients. each subject will participate in the study for up to approximately 14 weeks. this includes a screening period, drug treatment period, and post-treatment safety follow-up period. this is a crossover design study, in which subjects will be administered with sr419 and placebo according to their randomized sequence, that is, eligible subjects will be randomized in a 1:1 ratio to 1 of 2 double-blind treatment sequences: 30 mg of sr419 administered tid followed by placebo administered tid or placebo administered tid followed by 30 mg of sr419 administered tid.

Eligibility criteria:
inclusion criteria: 1. adult male or female over 18 years old; 2. having neuropathic pain of postherpetic neuralgia (phn) that persists for \>3 months after the herpes zoster rash is healed, with the pain area of a continuous area of affected rash. 3. dn4 score is ≥4 at screening; 4. average pi-nrs score of phn-associated neuropathic pain over the last 24 hours at screening is ≥4 and ≤9; 5. female subjects must be non-pregnant and non-lactating; exclusion criteria: 1. other pains that cannot be clearly differentiated from phn and may interfere with phn assessment; 2. circumstances that may affect pain assessment as determined by the investigator, such as skin disorders in the affected skin area that may affect sensation; 3. active herpes zoster infection at screening; 4. serious acute or chronic medical condition that, as assessed by the investigator, could increase the risks in subjects for participating in the trial or taking the study drug, or interfere with the study results; 5. previous administration of other study drugs within 30 days or 5 half-lives before the study intervention used in this study (whichever is longer).
evaluation of lactobacillus fermentum cect5716 on the incidence of mastitis

Conditions: Mastitis

Summary: to evaluate the effect of the consumption of lactobacillus fermentum cect5716 on mastitis incidence.

previous studies have demonstrated that l. fermentum cect5716, a probiotic strain previously isolated from breast milk, can be used as an effective treatment of mastitis and painful breastfeeding by reducing pathogen counts in breast milk. this is a randomized double blinded controlled study to evaluate the effect of l.fermentum cect5716 on mastitis incidence and staphylococcus load in breast milk. women will be recruited 1-6 days after child birth and distributed into two groups: probiotic group receiving 1 capsule/day containing l.fermentum 3x109cfu; control group receiving 1 placebo capsule/day containing maltodextrin. the intervention period is 16 weeks.

Eligibility criteria:
inclusion criteria: * healthy women between 18 and 40 years with development of normal pregnancy birth between 37 and 42 weeks of gestation. women who have received antibiotic treatment between 48 hours before and 48 hours after childbirth (one dose is sufficient for inclusion regardless of the type of antibiotic). childbirth took place 1-7 days prior to recruitment.. with firm intention to breast-feed their children for at least 16 weeks.. exclusion criteria: * - mammary pathologies that hinder or preclude breastfeeding. * low expectation of adherence to the study protocol.
association between outcomes of bariatric surgery and preoperative gastrointestinal microbiota

Conditions: Obesity, Morbid

Summary: purpose the aim of this study was to analyze the microbiota of patients undergoing lsg or lrygb on three levels of gastrointestinal tract, using oral swab and stool sample. we compared samples from patients achieving favorable outcomes in terms of weight-loss with patients, who did not respond optimally to the bariatric operation. materials and methods design this prospective cohort study was conducted in one academic, teaching hospital. the recommendations of the metabolic and bariatric surgery section of the polish surgical society were used as indication for surgery, that is: body mass index (bmi) ≥35 kg/m2 with obesity-related comorbidities or bmi ≥40 kg/m2 . analysis and endpoints primary endpoint was to determine the difference in microbiota present in oral cavity and large intestine between patients ing group 1 and group 2. secondary endpoint was to compare the results of microbiota analysis between lsg and lrygb.


Eligibility criteria:
inclusion criteria: * informed consent to participate in the study, meeting the eligibility criteria for bariatric treatment, either for lsg or lrygb. exclusion criteria: * type 1 or type 2 diabetes, treatment with antibiotics within 30 days prior to gathering microbiological material, treatment with probiotics within 30 days prior to gathering microbiological material, gastrointestinal infections, inflammatory bowel disease, thyroid diseases, cancer (especially the digestive tract), immunodeficiency.