Kornimate/medical-research-clean huggingface dataset:
effect of intermittent oro-esophageal tube feeding vs. nasogastric tube feeding on dysphagia patients after stroke

Conditions: Stroke

Summary: this was a prospective multicenter study. the patients after stroke with were randomly divided into the observation group and the control group. all patients were given comprehensive rehabilitation therapy. during the treatment, enteral nutrition support was provided for the two groups by intermittent oro-esophageal tube feeding and nasogastric tube feeding, respectively. nutritional status, dysphagia, quality of life and depression before and after treatment were compared.

dysphagia in patients after stroke continues to be a challenge. to avoid the wound caused by gastrostomy, nasogastric tube feeding has been the mainstay of palliation, but potential side effects exist this choice. intermittent oro-esophageal tube feeding is an established modality that can be used with comprehensive rehabilitation therapy. this study reports the outcomes of intermittent oro-esophageal tube feeding and comparison with nasogastric tube feeding, including nutritional status, dysphagia, quality of life, depression, and follow-up in patients receiving comprehensive rehabilitation therapy.this was a prospective multicenter study. the patients after stroke with were randomly divided into the observation group and the control group. all patients were given comprehensive rehabilitation therapy. during the treatment, enteral nutrition support was provided for the two groups by intermittent oro-esophageal tube feeding and nasogastric tube feeding, respectively. nutritional status, dysphagia, quality of life and depression before and after treatment were compared.

Eligibility criteria:
inclusion criteria: * age ≥ 18 years; * meeting the diagnostic criteria of stroke; * any degree of dysphagia at admission; * steady vital signs, without severe cognitive impairment or sensory aphasia, able to cooperate with the assessment. * transferred out within three weeks of hospitalization in the neurology department. exclusion criteria: * complicated with other neurological diseases; * damaged mucosa or incomplete structure in nasopharynx; * tracheostomy tube plugged; * unfeasible to the support of parenteral nutrition; * simultaneously suffering from liver, kidney failure, tumors, or hematological diseases.
pharmacokinetics of bisoprolol and sglt2i in acutely decompensated heart failure

Conditions: Acute Decompensated Heart Failure

Summary: the pharmacokinetics (pk) and pharmacodynamics (pd) of bisoprolol and sodium-glucose co-transporter-2 inhibitors (sglt2i, dapagliflozin and empagliflozin) in patients with acutely decompensated heart failure (adhf), compared to the recompensated state, is unknown. if not in cardiogenic shock (no need of vasopressor (catechoalmines) therapy or other inotropic support), established oral betablocker therapy should de continued. whether this holds true for sglt2i in adhf is less clear but current evidence suggest safety and potentially beneficial effects in doing so. to the best of our knowledge, no data regarding pk/pd are available for the most widely used beta blocker bisoprolol and the newly approved/in germany available sglt2i dapagliflozin and empagliflozin. this study shall provide first evidence on the pk/pd-profile of p.o. bisoprolol and sglt2i (dapaglifozin or empagliflozin) regarding acute (hemodynamic) effects and safety as well as to provide data on dose recommendations eventually in patients with adhf.


Eligibility criteria:
inclusion criteria: * patients with decompensated heart failure caused by heart failure irrespective of ejection fraction (heart failure with reduced, mildly reduced or preserved ejection fraction and de-novo heart failure) * signs of decompensation: peripheral edema, jugular venous distension, pulmonary rales, protodiastolic gallop rhythm, ascites, or demonstration of pulmonary venous congestion on chest x-ray * previous documented beta blocker therapy * elevated natriuretic peptides (nt-pro-bnp ≥125 pg/ml) * patients admitted to the intensive care unit exclusion criteria: * left ventricular or biventricular assist device therapy * cardiogenic shock * need of vasopressor (catechoalmines) therapy or other inotropic support (dobutamine or levosimendan) * clinical symptomatic hypotension * bradycardia (\<50 bpm) * patients requiring dialysis (cvvhd) * inflammatory bowel disease (eg, m. crohn or colitis ulcerosa) * not able to give written informed consent

Keywords: acute decompensated heart failure bisoprolol sglt2-inhibitors pharmacokinetics pharmacodynamics
efficacy of auricular acupuncture on neonatal abstinence syndrome

Conditions: Neonatal Abstinence Syndrome

Summary: this study will assess the efficacy of needle auricular acupuncture (aa) in neonatal abstinence syndrome (nas) infants who require pharmacologic therapy at the tampa general hospital nicu. the investigators will evaluate efficacy of needle aa as an adjunct treatment for nas by means of total methadone dose exposure, peak withdrawal scores, and overall length of stay. this is the first study to evaluate efficacy of needle aa as an adjunct treatment for nas by means of total methadone dose exposure, peak withdrawal scores, and overall length of stay.

enrolled infants will be randomized to a control group and an acupuncture group. the control group will receive nonpharmacologic and pharmacologic management as per our current standard of care. the acupuncture group will additionally receive aa. once the infant is enrolled, he/she will be randomized to the aa group or the control group. both groups of randomized infants will be taken daily to a designated treatment room. infants in the control group will not receive acupuncture, and will only receive observation in the treatment room and will have review of their emr. if in the aa group, the investigator will evaluate the infant using an ear point locator to determine active sites prior to each needle placement. acupuncture infants will have needles placed in any active sites found in one ear (up to 5 needles). acupuncture sites will be alternated daily between right and left ear. acupuncture will be discontinued on the same day as methadone is discontinued, or if infant is cleared to be discharged home on methadone, acupuncture is discontinued when infant reaches the discharge dose of methadone. data for both groups will be collected on the day of enrollment, every three days during study participation, and at hospital discharge.

Eligibility criteria:
inclusion criteria: 1. gestational age ≥ 35 0/7 weeks assessed by the obstetrical team from dating of last menstrual period, ultrasound, or best obstetric estimate 2. admitted to the tgh transition nursery or nicu with a diagnosis of nas, or maternal / infant positive urine drug screen result 3. may have any of the following additional diagnoses at the time of admission: late prematurity, hyperbilirubinemia, hypoglycemia, sepsis without hypotension, respiratory distress without requiring support, or temperature instability 4. parents give written consent prior to starting pharmacologic treatment for nas 5. aa needles are placed within 9 hours of infant's initial nicu finnegan score \>4 exclusion criteria: 1. helix or antihelix of ear is deformed and needle is unable to be placed 2. skin condition around the ear 3. a suspected or confirmed genetic or metabolic syndrome 4. department of children and families investigation results in termination of parental rights

Keywords: aa for nas
randomized trial of a sleep disorders program on firefighter safety and disability ...

Conditions: Sleep Disorder

Summary: the investigators have shown that sleep health education and sleep disorders screening improve health and safety of employees. there is potential to increase the benefits of the sleep health education and screening program if more firefighters are evaluated, diagnosed and referred for treatment. investigators will evaluate whether firefighters in stations randomized to participate in the sleep health and education program (shep) intervention will have improved health and safety outcomes as compared to firefighters in stations randomized to the control condition.


Eligibility criteria:
inclusion criteria: * firefighters working in one of the two fire departments selected for study exclusion criteria: * none
bariatric surgery and pharmacokinetics of ibuprofen

Conditions: Obesity, Morbid

Summary: changes to gastric ph, gastric emptying time, gastrointestinal transit-time or the pre-systemic metabolizing effect of enzymes secreted in the mucosa may all alter the pharmacokinetics of medicines. these factors are potentially influenced by bariatric surgery. little is so far known about how gastric bypass and sleeve gastrectomy impacts the biological availability of medication. in this study the pharmacokinetic effects of bariatric surgery on ibuprofen are investigated.


Eligibility criteria:
inclusion criteria: * preparing to undergo gastric bypass or sleeve gastrectomy in central norway * being a norwegian citizen exclusion criteria: * having previously undergone resections in the gi-tract

Keywords: bariatric surgery gastrointestinal tract biological availability pharmacokinetics ibuprofen
endocone single port versus conventional multi-port laparoscopic approach

Conditions: Gallstones

Summary: its main objective is to evaluate the clinical outcome (including patient reported outcomes) and health economic assessment (hta) of a new re-usable system for single port laparoscopic surgery - endocone system developed by prof cuschieri by undertaking a randomised controlled prospective clinical trial (rct) on specific operations performed (on a random allocation basis) by either the traditional multi-port laparoscopic approach or the single port- endocone system by karl storz. to this effect, 300 patients meeting the trial inclusion criteria will be randomised over a three year period to have the operation by either of the two approaches.


Eligibility criteria:
inclusion criteria: * patients with symptomatic gallstone disease * asa i/ii * age between 18 and 80 years exclusion criteria: * asa iii or more * significant co-morbid cardiovascular, neurological diseases, diabetics and chronic obstructive airway disease * patients with previous history of invasive cancer * patients with previous surgery * patients requiring urgent/emergency interventions

Keywords: multiport laparoscopy single port laparoscopy symptomatic gallstones
neurological complications at stroke patients with diabetes mellitus

Conditions: Stroke; Diabetes Mellitus

Summary: it is to be investigated if a correlation exist between the development of the hba1c value and the complication rate is following a stroke.

the immediate objective of the study is to find out if a correlation between blood sugar control in diabetics and the incidence of complications after a stroke exists. the study has a high practical importance because any consequences in the treatment of diabetes mellitus can be implemented without affecting costs.

Eligibility criteria:
inclusion criteria: * stroke patients on the stroke unit with hyperglycemia with cerebral ischemia within the last 24 hours exclusion criteria: * patients with intracerebral hemorrhage * pregnant patients * patients with sensory aphasia

Keywords: diabetes mellitus stroke
nilotinib versus standard imatinib (400/600 mg every day (qd)) comparing the kinetics of complete molecular response for chronic myelogenous leukemia in chronic phase (cml-cp) pts with evidence of persistent leukemia by real-time quantitative polymerase chain reaction (rq-pcr)

Conditions: CHRONIC MYELOGENOUS LEUKEMIA

Summary: the primary goal of this study was to determine the rate of confirmed best cumulative complete molecular response (cmr) within the first year of study therapy with imatinib or nilotinib. the study also explored the impact and significance of the achieved cmr on patient outcomes (progression free survival (pfs), event free survival (efs) and overall survival (os), characterized the kinetics of cmr achieved in both treatment arms and after the cross-over.


Eligibility criteria:
inclusion criteria: diagnosis of chronic myeloid leukemia associated with bcr-abl quantifiable by rq-pcr documented ccyr by bone marrow or bcr-abl\<1% is in the past 12 months persistent disease demonstrated by two pcr positive tests 3 months apart both during the past 6 months. treatment with imatinib for at least 2 years with 400 mg or 600 mg and a stable dose no other current or planned anti-leukemia therapies exclusion criteria: patient has evidence of rising pcr (a confirmed \>1 log increase in previous 6 months) patient has received another investigational agent within last 6 months or tyrosine kinase inhibitors (tkis) other than imatinib prior allogeneic stem cell transplantation impaired cardiac function including any one of the following: inability to monitor the qt interval on electrocardiogram (ecg) long qt syndrome or a known family history of long qt syndrome. clinically significant resting brachycardia (\ 450 msec on baseline ecg (using the qtcf formula). if qtcf \>450 msec and electrolytes are not within normal ranges, electrolytes should be corrected and then the patient re-screened for qtc myocardial infarction within 12 months prior to starting study other clinically significant uncontrolled heart disease (e.g. unstable angina, congestive heart failure or uncontrolled hypertension) history of or presence of clinically significant ventricular or atrial tachyarrhythmias administration of cytokine therapy (e.g. g-csf, gm-csf or scf) within 4 weeks prior to study entry

Keywords: myelogenous leukemia chronic phase cml
hemoglobin, neutrophil to lymphocyte ratio and platelet count improve prognosis prediction in nasopharyngeal carcinoma

Conditions: Nasopharyngeal Neoplasms; Blood Cell Count; Neoplasm Staging; Prognosis

Summary: rationale 1. in patients with nasopharyngeal carcinoma, there is sometimes a discrepancy between actual clinical outcome and tnm stages because it is an anatomy-based system in which functional factors are not concerned. 2. hemoglobin, neutrophil to lymphocyte ratio and platelet count were proved to improve prognosis prediction of tnm staging system in our previous retrospective study. purpose to validate that the prognostic index based on complete blood count and tnm system had higher prediction efficiency on survival in nasopharyngeal carcinoma than tnm system alone.

totally 720 patients with non-metastatic nasopharyngeal carcinoma will be include and will be divided into 3 groups (low risk, intermediate risk and high risk groups) according to their prognostic index, which is on basis of blood cell count indexes and tnm stage. the 3 groups of patients will undergo a radical radiotherapy or chemoradiotherapy and be followed until death or the end of the study. comparison on survivals of the 3 groups will be made to validate the accuracy of the prognostic index. and comparison on prediction efficacy between prognostic index and tnm staging system will be made.

Eligibility criteria:
inclusion criteria: * nasopharyngeal cancer patients diagnosed by pathology or cytology * uicc/ajcc 2010 stage t1-4 n0-3 m0 * male or female patients with age between 18 and 75 years old * karnofsky performance scores ≥ 60 * expected survival ≥ 3 months * without dysfunction of heart, lung, liver, kidney and hematopoiesis exclusion criteria: * karnofsky performance status score \< 70' * radiotherapy uncompleted (≥ 1 fraction missing) * distant metastases before or during radiotherapy * without weekly complete blood count during radiotherapy * application of colony stimulating factor such as erythropoietin * signs of infection before radiotherapy.
psychological support in adult patients with marfan syndrome

Conditions: Rare Diseases; Marfan Syndrome; Psychology, Social

Summary: the goal of this observational study is to identify key factors leading to psychotherapy or psychological support in adult subjects with marfan syndrome (msf). the main questions it aims to answer are: * understand and define which internal variables of the individual drive this request for psychological support; * to learn about verify the impact that the clinical manifestations of msf have on psychosocial aspects, self-esteem, subjective perception of the disease and coping mechanisms.

patients following psychological interview during follow-up visits will be enrolled in the study. the following self-report questionnaires will be used in understanding the impact the syndrome has on mental health and quality of life: * rosenberg self- esteem: 10 item likert scale for assessing self-esteem; * sf 36: 36 item scale assessing eight domains: physical functioning physical role limitations; bodily pain; general health perceptions; energy/vitality; social functioning; emotional role limitations and mental health; * cope nvi: to test measures coping behaviors as potential responses to stressors like social support, avoidance strategies, positive attitude, problem orientation and transcendent orientation; * oq45.2: measure of general psychological distress.

Eligibility criteria:
inclusion criteria: * subjects affected by marfan syndrome; * subjects currently in follow-up at cardiovascular genetic centre, irccs policlinico san donato; * signed informed consent. exclusion criteria: * subjects with cognitive deficits

Keywords: marfan syndrome psychological support self-report
investigating a wrist-sensor oximeter to screen for sleep apnoea.

Conditions: Obstructive Sleep Apnea

Summary: the primary study objective is to investigate sensitivity and specificity of a wrist sensor pulse oximeter (the oxitone medical oxitone 1000m device) to screen for obstructive sleep apnoea. this study will involve thirty participants attending a sleep centre suspected of suffering from obstructive sleep apnoea (case finding screening). the secondary objective is to assess patient convenience with the screening procedure.

this is an observational study to assess the sensitivity and specificity of a wrist sensor pulse oximeter (oxitone medical oxitone 1000m) to identify obstructive sleep apnoea cases in patients referred to the london sleep centre (case finding screening, or case only study). the wrist sensor pulse oximeter streams data (pulse rate, heart rate variability (hrv), blood oxygen saturation levels (spo2), actigraphy data and skin temperature data) to a software application using bluetooth connectivity to be stored in a securely encrypted database cloud for analysis. the investigators at the sleep centre will be masked when analysing the data from the wrist sensor pulse oximeter when deciding on diagnosis of obstructive sleep apnoea. data from the wrist sensor oximeter device will be statistically compared with the data from a conventional ppg fingertip oximeter and peripheral arterial tonometry device currently in use. the study outcome will be whether the wrist sensor pulse oximeter device could be used in patients to screen reliably for obstructive sleep apnoea. the study also will include patient feedback on convenience of the screening procedure. the study will not affect routine patient medical management and care for patients assessed at the sleep centre.

Eligibility criteria:
inclusion criteria: * thirty consecutive patients referred to the sleep centre for screening for sleep apnoea that consented to involvement in the study. exclusion criteria: * patients who are unable to give written informed consent. * anaemia or dysfunctional hemoglobin * upper limb complaints affecting the ability to wear the watch like wrist sensor device such as tenderness, deformity or swelling, skin complaints such as ulceration, swelling or skin breaks * impairment in circulation in the left upper limb (active raynauds or other vascular impairment) * neurological conditions such as tremor or convulsions * medical conditions likely to affect the blood oxygen such as chronic obstructive pulmonary disease (copd) and chronic asthma * neurological conditions likely to affect breathing such as stroke * conditions likely to affect autonomic nervous system such as diabetes mellitus

Keywords: screening, patient convenience
early pain finding in infants with brachial plexus birth injury

Conditions: Brachial Plexus Palsy

Summary: in brachail plexus birth palsy (bpbi), fractures, glenohumeral joint dislocation, torticollis and plagiocephaly, facial nerve palsy, phrenic nerve palsy, obesity, speech delay, integumentary system problems, and central nervous system disorders are common comorbidities. clinical assessments such as observation, palpation, and radiologic imaging are commonly used to identify early period comorbidities after delivery .since fractures or joint deformities may occur in the affected upper extremity due to high-energy trauma at birth, pain assessment in the early postnatal period is recommended and several objective assessment methods have been proposed. due to the difficulty of pain assessment in early childhood, the assessment is mostly performed by palpation. pain is suspected if the baby grimaces with light palpation of the neck and upper shoulder area. although some hospitals have adopted objective assessment of pain and objective assessment is recommended, the level of pain in early childhood has not been investigated. therefore, the aim of our study was to determine the level of pain in bpbi in early childhood and to examine the relationship between pain and motor function. in addition, the second aim of the study is to determine the cut-off value of the pain level that may be a sign of fracture in patients with bpbi, in order to suspect a fracture in the shoulder region and request additional examinations. the diagnosis of bpbi, determination of narakas classification and evaluation of comorbidities were performed by a senior orthopedic surgeon. after the initial doctor's examination, patients are routinely referred to the physiotherapy clinic for a physiotherapy evaluation.in the assessment, active joint movement and pain assessments of children were used, and all of these assessments were performed by a hand and pediatric physiotherapist.


Eligibility criteria:
inclusion criteria: * having diagnosis of brachial plexus birth injury (bpbi), * being initial evaluation and not having started treatment before, * being in the age range of 15-90 days old, * consent to participate in the study. exclusion criteria: * children with bpbi who are older than 90 days or younger than 15 days, * starting regular physical therapy or home program before applying to our hospital, * pseudo-paralysis that are diseases that may show symptoms similar to bpbi (clavicle or humerus fracture only, pseudo-paralysis not bpbi injury, glenohumeral joint septic arthritis, arthrogryposis multiplex congenita (amc), cerebral palsy, spinal cord ischemic injury, spinal cord congenital aplasia, spinal tumor, congenital radial palsy).