Kornimate/medical-research-clean huggingface dataset:
minimum effective volume of ropivacaine 7.5 mg/ml for the lateral and sagittal infraclavicular brachial plexus block

Conditions: Pain

Summary: systemic la toxicity is an important complication of regional anesthesia. lowering the la dose is one of the strategies to reduce this risk. for upper limb blocks it is well documented that ultrasound guidance allows a significant lower dose of la for interscalene and axillary blocks than with guidance by peripheral nerve stimulation. however, a corresponding difference has not yet been found for supraclavicular and infraclavicular blocks. the aim of the present study is to define the minimum effective volume of ropivacaine 7.5 mg/ml when using the lsib method.

the blocks will be performed as previously described, by an anesthesiologist with lsib expertise. the lateral, medial and posterior cords are the target of infra-clavicular brachial plexus blocks. during a prescan we will record if they can be visualized by ultrasound and indicate their positions periarterially. the deep location of the cords may hamper their identification, especially that of the medial cord. we describe the cord positions with reference to the short-axis (cross-sectional) view of the axillary artery, which is compared to a clockface having 12 o'clock ventrally. in a former mri study it was found that the cords were usually located in a sector from 3-11 o'clock (the 3-11 sector) and within a distance of 2 cm from the midaxis of the axillary artery. the point closest to the cords was at 8 o'clock, immediately outside the arterial wall. point of needle insertion is at the intersection between the lower edge of the clavicle and the medial surface of the coracoid process. we direct the needle tip to the 8 o'clock position and observe the spread of la from this position. on demand we adjust the needle position to secure a complete fill of the 3-11 sector with la (multiple injections). the block needle has an electrical cable. prior to la injections we test if a minimal electric output (0.2 ma/0.1 msec duration) elicits a motor response. if such a response is obtained, the needle is withdrawn (in steps of 1 mm), until the motor response disappears. this is to reduce the risk of intraneural injection.

Eligibility criteria:
inclusion criteria: * patients of american society of anesthesiologists physical status (asa) i-ii * scheduled for surgery distal to the elbow. * duration of surgery \>1 hour. * age 18-65 years, * body mass index 20-35 kg/m2 exclusion criteria: * pregnancy * any contraindication to regional anesthesia * patients on major opioids because of chronic pain * atrioventricular block * pacemaker * diabetes * peripheral neuropathy

Keywords: ropivacaine brachial plexus
effect of a respiratory training program on woodwind and brass players

Conditions: Respiratory Function

Summary: this project will study the effect of a respiratory training program on woodwind and brass players, using an inspiratory muscle training equipment. the goal is to understand whether it is possible to develop the inspiratory muscles of wind players through regular and planned training. fourteen young wind players will be selected, in which 7 will be male and 7 will be female, playing different instruments. inspiratory muscle training will be performed with the powerbreath plus medium resistance, and will consist of 30 maximal inspirations, twice a day, for 5 weeks.

this project will study the effect of a respiratory training program on woodwind and brass players, using an inspiratory muscle training equipment. the goal is to understand whether it is possible to develop the inspiratory muscles of wind players through regular and planned training. fourteen young wind players will be selected, in which 7 will be male and 7 will be female, playing different instruments: transverse flute (1), oboe (2), saxophone (4), horn (4), trumpet (1), trombone (1) and tuba (1). inspiratory muscle training will be performed with the powerbreath plus medium resistance, and will consist of 30 maximal inspirations, twice a day, for 5 weeks. the participants will be instructed on the use, handling and cleaning of the equipment. the participants will be instructed to use the equipment in a comfortable position, with a good posture, and will be instructed on how they should execute the inspiratory training: inhale to the maximum limit, with intensity, and exhale slowly and relaxed. an explanation will also be given about the calibration of the powerbreathe, and the initial resistance level will be established based on the calculation of 50% of the maximal inspiratory pressure of each participant, previously measured. participants will also be instructed on how to increase the resistance level of powerbreathe. the increase would be 1/4 of a level, whenever they no longer feel tired after a 30-inhalation workout. a questionnaire will be applied before, during and after the inspiratory training and they will be asked to record the daily use of the equipment in an online form, created for the purpose of recording its use by each participant. assessment will be executed with the standard borg scale and the modified borg scale. surface electromyography (semg) of the right sternocleidomastoid, the right scalene muscles, the diaphragm and the right rectus abdominis will also be tested. maximal inspiratory pressure and spirometry testing, specifically volume of forced vital capacity (fvc) or forced expiratory volume in one second (fev1) and fev1/fvc ratio will also be assessed.

Eligibility criteria:
inclusion criteria: * 18 years of age or over * 10 years of musical experience exclusion criteria: * lung disease

Keywords: inspiratory muscle training lung capacity musicians
breastfeeding preterm infants - the efficacy of internet-based peer support

Conditions: Breast Feeding; Infant, Premature

Summary: this study examines if the internet-based peer support has an effect on the breastfeeding attitude or the duration of breastfeeding in preterm infants and their mothers compared with mothers with routine care. the factors associated with the initiation of breastfeeding in the neonatal intensive care unit will be determined. in addition, the perceptions of the mothers of preterm infants about their needs and problems when breastfeeding their preterm infants are described.


Eligibility criteria:
inclusion criteria: * mothers giving birth before full 35 gestational weeks in a study hospital exclusion criteria: * the mother not able to speak finnish * the infant's condition is critical (based on the paediatrician), * the mother has a syndrome or illness preventing breastfeeding
resiliency training on the college campus

Conditions: Psychotic Disorders; Mood Disorders; Anxiety Disorders

Summary: this is a waitlist controlled study examining the initial efficacy of resilience training among college students at an elevated risk for a severe mental illness.


Eligibility criteria:
inclusion criteria: 1. 18-30 years old 2. enrolled in undergraduate program at the college or university where the intervention takes place 3. students who endorse delusion-like experiences (dles): peter's et al. delusion inventory (pdi) score \> 4 and/or 4. students with mild to moderate depressive symptoms: beck depression inventory (bdi) score ≥ 6 exclusion criteria: 1. inability to provide informed consent 2. not proficient in english 3. current self-reported diagnostic statistical manual 5 (dsm-5) diagnosis with active symptoms (such as active psychotic symptoms, current suicidality, serious active alcohol or substance use, marked deterioration in functioning over the prior month) determined by clinical interview with participant, or self-report of a psychiatric diagnosis that necessitates close monitoring or individual therapy and/or inpatient or partial hospitalization 4. current enrollment in psychological or behavioral health treatment. 5. current use of psychotropic medications (other than stimulants) prescribed by a physician.
non-invasive respiratory monitoring during sbt

Conditions: Mechanical Ventilation Complication; Acute Respiratory Failure; Re-intubation Rate

Summary: spontaneous breathing trials (sbts) assess readiness for extubation, yet the use of conventional parameters used to establish weaning success may be elusive, especially in high-risk patients. currently, non-invasive techniques allow comprehensive bedside assessment of advanced respiratory mechanics, including metrics of respiratory system compliance (crs), respiratory muscle effort (pocc) and respiratory drive intensity (p0.1). this study investigates whether these measurements during sbt may improve the prediction of extubation outcomes


Eligibility criteria:
to be eligible, patients had to meet all of the following criteria: 1. age ≥ 18 years. 2. the presence of ≥ 1 among the following factors to define the high-risk for re-intubation: age older than 65 years; heart failure as the primary indication for mechanical ventilation; moderate to severe chronic obstructive pulmonary disease (copd); an acute physiology and chronic health evaluation ii (apache ii) score higher than 12 on extubation day; body mass index of more than 30; inadequate cough reflex or suctioning \>2 times within 8 hours before extubation; prolonged use of invasive ventilation (≥ 7 days from the first sbt); more than 2 comorbidities categorized based on the charlson comorbidity index. 3. deemed ready to be weaned from the ventilator, based on the following criteria: (a) invasive mechanical ventilation for more than 48 hours, including at least 12 hours of pressure support ventilation with peep ≤ 8 cmh2o and pressure support ≤ 10 cmh2o; (b) improvement of the condition leading to intubation; (c) patient making inspiratory effort; (d) adequate gas exchange, as indicated by a ratio of partial pressure of arterial oxygen (pao2) to inspiratory fraction of oxygen (fio2) ≥ 150 with fio2 ≤ 40% and arterial ph within normal range (7.30 - 7.50); (e) glasgow coma score higher than 13; (f) a core temperature below 38°c; (g) richmond agitation and sedation scale between -1 and +1. eligibility required readiness for scheduled extubation after successfully completing a 30-minute sbt in the pressure-support mode (7 cmh₂o) sbt success was defined by the following criteria \[19\]: (a) adequate gas exchange, as indicated by a ratio of partial pressure of arterial oxygen (pao2) to inspiratory fraction of oxygen (fio2) ≥ 150 with fio2 ≤ 40% and arterial ph within the normal range (7.30 - 7.50); (b) respiratory rate \< 35/min; (c) spontaneous tidal volume higher than 5 ml of predicted body weight (pbw); (d) a ratio of respiratory rate to tidal volume (i.e. the rapid shallow breathing index, rsbi) \< 105/min per liter; (e) systolic blood pressure between 90 and 160 mmhg and heart rate \< 140/min, with or without low doses of vasopressors (\< 0.5 mcg/kg/min). exclusion criteria were tracheostomy, patients undergoing withdrawal of life-sustaining treatments, known neuromuscular diseases.

Keywords: spontaneous breathing trial extubation failure lung mechanics airway occlusion pressure noninvasive monitoring
pain relief from dysmenorrhea employing tavns

Conditions: Dysmenorrhea Primary

Summary: the goal of this clinical trial is to determine if transauricular vagal nerve stimulation (tavns) is effective in treating moderate dysmenorrhea. the main question it aims to answer is: • does tavns reduce the number of times participants suffering from dysmenorrhea need to use rescue medication during menstruation? researchers will compare tavns stimulation with a sham stimulation (a look-alike procedure that does not stimulate the vagus nerve) to assess whether tavns is effective in treating moderate dysmenorrhea. participants will: * undergo tavns for 2 months and sham stimulation for another 2 months, each for 5 days per month, starting 2 days before the expected beginning of their menstrual cycle. * visit the clinic twice a month for checkups and tests. * keep a diary to record their pain levels and the number of times they use rescue medication. * undergo functional magnetic resonance imagine two times (one after the end of the first use of tavns and another after the end of the first use of sham stimulation).


Eligibility criteria:
inclusion criteria: * regular menstrual cycle (28 days ± 7 days); * average moderate menstrual pain (with 4 - 7 nrs scores); * history of over-the-counter (otc) analgesic use for the treatment of menstrual pain (at least 1 ibuprofen for the first two days); * 4 consecutive monthly menstrual cycles; * non-pregnant status; * agrees to use adequate birth control during the trial; * otherwise, healthy; * agree not to participate in any other clinical trial while enrolled in this trial ; * no facial or ear pain, no recent ear trauma, no metal implants including pacemakers; * normal ecg, heart rate and blood pressure (systolic bp 105-130, diastolic bp 60-90, heart rate per min at rest 60-85); exclusion criteria: * currently under medications (except for analgesic medication for menstrual cycle); * use of oral contraceptive; * secondary cause for dysmenorrhea (i.e., endometriosis, adenomyosis, uterine fibroids, or infection); * unstable or serious illness (e.g., kidney, liver, git, heart conditions, diabetes, thyroid gland function, lung conditions, chronic asthma, diagnosed psychological or mood disorder, hypertension, any bleeding disorders, recent surgery, or concurrent blood thinning treatment); * current malignancy or treatment for malignancy within the previous 2 years; * pregnant or lactating women; * active smokers, nicotine use, or drug (prescription or illegal substances) abuse; * chronic past and/or current alcohol use (\>14 alcoholic drinks per week); * any condition that in the opinion of the investigator, makes the participant unsuitable for inclusion; * unwilling or unable to comply with protocol; * active genitourinary infection in the last four weeks; * unable to read or comprehend the informed consent; * unwilling to complete study procedures; * participated in any other clinical trial during the past 1 month; * personal or family history of seizure, mood, or cardiovascular disorders; * allergic reaction to surface electrodes.

Keywords: dysmenorrhea transauricular vagal nerve stimulation pain
a pilot comparison study of vibrating mesh versus standard jet nebuliser for bronchodilator delivery in copd

Conditions: Chronic Obstructive Pulmonary Disease (COPD)

Summary: treatment of chronic obstructive pulmonary disease (copd) incorporates various modes of inhalation therapy. the response to treatments is dose dependent thus applying the most efficient device to administer the treatment is integral. evaluation of the efficacy of nebulisation devices in the treatment of copd is limited. technological development in recent years has led to new devices that optimize lung deposition and reduce the time needed for treatment. the aim of this study is to compare the vibrating mesh and jet nebuliser methods of delivering bronchodilator medication to patients hospitalised with an acute exacerbation of copd, with respect to lung function and efficacy in spontaneously breathing patients.

treatment of chronic obstructive pulmonary disease (copd) incorporates various modes of inhalation therapy. the response to treatments is dose dependent thus applying the most efficient device to administer the treatment is integral. evaluation of the efficacy of nebulisation devices in the treatment of copd is limited. technological development in recent years has led to new devices that optimize lung deposition and reduce the time needed for treatment. the aim of this study is to compare the vibrating mesh and jet nebuliser methods of delivering bronchodilator medication to patients hospitalised with an acute exacerbation of copd, with respect to lung function and efficacy in spontaneously breathing patients. patients admitted to hospital with an exacerbation of copd and prescribed regular nebulised bronchodilators (combined salbutamol 2.5mg and ipratropium 0.5mg) will be recruited to the study. on one occasion between day 3-7 of admission they will perform pulmonary function testing namely measurement of forced expiratory volume in 1 second(fev1), forced vital capacity (fvc), inspiratory capacity (ic) and cough peak flow. they will also complete the borg breathlessness score. measurements will be recorded at baseline (pre-bronchodilator administration) and one hour post-nebulised bronchodilator. patients will be randomised to receive their nebulised bronchodilators via the standard hospital jet nebuliser or via a vibrating mesh nebuliser(aerogen solo). change in lung function and symptom measures between baseline and one-hour post nebulisation will be analysed to look for any significant difference between the two groups

Eligibility criteria:
inclusion criteria: * hospital inpatients admitted with an acute exacerbation of copd * age \>40 * copd stage 2-4 moderate to severe (fev1/fvc \<0.70;fev1\<80%) * history of physician-diagnosed copd * copd exacerbation between day 2 and day 7 of admission exclusion criteria: * confusion * significant hypoxia/unstable medical condition * allergy or contraindication to salbutamol and/or ipratropium * pneumonia * pregnancy
overweight and obesity adversely affect ivf outcomes in women with pcos

Conditions: Polycystic Ovary Syndrome IVF

Summary: the effect of overweight and obesity on ivf outcomes is still questionable. the purpose of this study was to determine if overweight/obesity in women with pcos were associated with an adverse ivf outcome compared to those with normal weight. design: retrospective cohort study.


Eligibility criteria:
inclusion criteria: * all women within the age limit

Keywords: obesity in vitro fertilization (ivf) polycystic ovary syndrome (pcos)
hemodynamic effect of topical anesthesia during induction in patients undergoing cardiac surgery

Conditions: Coronary Artery Disease; Valvular Heart Disease; Arrythmia

Summary: patients scheduled for cardiac surgery are fragile. hemodynamic fluctuation might be associated with adverse outcomes. therefore, it is essential to keep hemodynamics stable during and after the induction period. previous studies have shown that topical anesthesia can provide excellent superior supraglottic and subglottic local anesthetic effects and can significantly reduce the dosage of intravenous anesthetics. therefore, we designed this study to explore whether the combination of topical anesthesia and intravenous anesthetics could decrease the stress response of endotracheal intubation and keep hemodynamics stable during and after the induction period.

patients scheduled for cardiac surgery are often accompanied by cardiac insufficiency. hemodynamic fluctuation might lead to disastrous events. therefore, it is essential to keep hemodynamics stable during and after the induction period. the routine anesthesia induction strategy for cardiac surgery is to decrease stress response during endotracheal intubation by using large doses of opioids. however, high doses of opioids often leads to persistent and recurrent hypotension in patients from the anesthesia induction period to the beginning of the surgery. previous studies have shown that topical anesthesia can provide excellent superior supraglottic and subglottic local anesthetic effects and can significantly reduce the dosage of intravenous anesthetics. therefore, we designed this study to explore whether the combination of topical anesthesia and intravenous anesthetics could decrease the stress response of endotracheal intubation and keep hemodynamics stable during and after the induction period.

Eligibility criteria:
inclusion criteria: 1. patients older than 18 years and younger than 75 years; 2. patients scheduled to accept elective cardiac surgery; 3. patients of new york heart association (nyha) ⅱ～ⅲ level grade ; 4. patients signed the informed consent form for the clinical study. exclusion criteria: 1. patients cannot cooperate to topical anesthesia; 2. patients who had left heart assist devices other than intra-aortic balloon counterpulsation before surgery; 3. patients treated with extracorporeal membrane oxygenation (ecmo) prior to surgery; 4. patients with aortic dissection; 5. patients with difficult airway; 6. patients with high sensitivity and hypersensitivity to lidocaine; 7. patients with atrioventricular block; 8. patients who have participated in other clinical studies during the last 3 months.

Keywords: topical anesthesia atomization inhalation cardiac surgery hemodynamics endotracheal intubation
total knee arthroplasty: functional and clinical outcomes

Conditions: Knee Osteoarthritis

Summary: the purpose of this study is to assess the differences in functional and patient reported outcomes between total knee replacement (tka) implants. in addition, this work will examine the correlation between functional assessments and patient reported outcomes following surgery. all subjects will complete assessments preoperatively, 4-6 weeks following tka and then one year following tka. subjects will complete a series of patient reported outcomes as well as a series of functional outcomes at each of the time points of interest. the analysis will include a repeated measures design to determine differences between groups across time as well as correlations between the functional and patient reported outcomes. this work will hopefully determine the importance of using objective functional outcomes following tka as well as determining the need for patient assessments out to one year following surgery.

the number differences in subjects analyzed from baseline to 6 weeks to 52 weeks are due to the fact that we did not use the 6 week time point in the final analysis based on the clinical decision that 6 weeks was too early in recovery to provide accurate information for clinical decision making. therefore the patients used in the final analysis were those subjects who were able to and completed the assessment at pre-op and 1 year post-op which is how we get to the 20 subjects per group.

Eligibility criteria:
inclusion criteria: 1. patients requiring primary total knee replacement 2. patients willing and able to comply with the follow-up visits and evaluations 3. patients willing to sign informed consent approved by the institutional review board exclusion criteria: 1. patients with inflammatory arthritis 2. patients with diabetic neuropathy 3. patients unable to ambulate without the use of an assistive device prior to surgery 4. patients unable to stand in single limb stance on each foot prior to surgery.

Keywords: total knee replacement lower quarter y-balance test functional outcomes patient reported outcomes