Kornimate/medical-research-clean huggingface dataset:
lidocaine-ketamine for management of chronic pain

Conditions: Chronic Pain Syndrome

Summary: chronic pain is defined as 'an unpleasant sensory and emotional experience associated with actual or potential tissues damage, or described in terms of such damage". it is estimated that 1 in 5 canadians experience chronic pain "chronic pain is associated with the worst quality of life compared with other chronic diseases such as chronic lung or heart disease". many of these problems are confined to a specific anatomic structure, and can be diagnosed and treated by injections, physical therapy, surgery, etc. nonetheless, other individuals experience a more generalized pain. this condition has also resulted i depressed mood, bad relations with other people, sleep disturbances and poor quality of life. the condition is very difficult to manage, and multiple methods have been recommended. therapeutic intravenous infusion may be considered as one of these methods. patients come for infusions of non-opioid medications under medical supervision and in a scheduled fashion. two most commonly used mediation are lidocaine and ketamine. even though it is common to use multiple medications with complementary mechanisms of action to treat pain a combined lidocaine-ketamine infusion has never been studied therefore, the purpose of this research study is to determine whether mixture of two medications (ketamine and lidocaine) infused intravenously 1 time per month for 6 months results in reduction of pain unpleasantness.


Eligibility criteria:
inclusion criteria: * age 18-90 * pain duration: \> 3 months * multifocal and/or non-dermatomal neuropathic pain per pain diagram * failed medical management with at least 2 neuromodulation agents (e.g., gabapentinoids, antidepressants) * neuropathic component (\>15 points on s-lanss) exclusion criteria: * non-english speakers * refusal to sign informed consent * body weight \> 100 kg * allergies to ketamine and/or lidocaine * known contraindications to ketamine use which include poorly controlled systemic illnesses: arterial hypertension, hyperthyroidism, ischemic heart disease, heart failure, psychiatric comorbidity (e.g., history of psychosis, schizophrenia, dissociative state). * known contraindication to lidocaine use which include current symptomatic or clinically significant brady- or tachyarrhythmia, systolic blood pressure \ 180 mmhg. * scheduled interventions targeting neuropathic pain: epidural injections, peripheral nerve blocks, bier block, radiofrequency of dorsal root ganglia and peripheral nerves, additional lidocaine or ketamine infusions * newly added analgesic or neuromodulating medications, or recently performed interventions including lidocaine infusions (in the previous 3 months), or previous lidocaine/ketamine infusion in the previous 360 days. -acute intoxication or active illegal substance abuse (excluding marijuana)

Keywords: lidocaine ketamine infusion
effectiveness of podiatry care on onychomycosis (epocaon)

Conditions: Onychomycosis

Summary: onychomycosis occurs in more than 50% of all pathologies unguinal, affecting the health and quality of life of the patient. although the investigators have a wide therapeutic arsenal, there is still a disparity when carrying out an effective processing. hypothesis/objectives: to analyze if the use of the podiatric technique of aggressive unguinal abrasion with micrometer sports, in combination with topical treatment with amorolfin 5% in hairspray, significantly increases the effectiveness clinically as well as mycology. the investigators will analyze the relationship between this intervention and the quality perception of life related to the health of the nails and the foot. the investigators will use results for next validation study in spanish of the questionnaire nailqol, as well as validation and reliability of the index scio and cost study-effectiveness of the processing. method: the investigators will design a randomized control trial. the town will be recruited, informed prior consent will be obtained from patients of 5 spanish centers of chiropody, with sample size of 313 patients. there will be a screening of 4 weeks to select patients with onychomycosis infections (clinic and mycology both positives); later the patients will be distributed randomly in 2 groups: * group am+au: will be administered aggressive unguinal abrasion, weeks 0 (baseline), 12 and 24, followed by standard treatment of amorolfin 5%, two weekly applications during 36 weeks. * group am: will be administered exclusively standard treatment of amorolfin 5%, according to common format. the duration will be 48 weeks.


Eligibility criteria:
inclusion criteria: * people of both sexes with ages between 18 and 75 years. * having affected at least the nail out of the first toe of a foot. * having a confirmed diagnosis of onychomycosis with positive and evidence clinic mycology (koh and cultivation) both positive ones. * the infection should be caused by a fungus dermatology. will not afford another type of infection because of the possibility of false positives for pollution exogen. exclusion criteria: * having received in 6 previous months some local treatment or systemic for the onychomycosis. * having dystrophies or alterations ungulates, apart from the ones specific to the onychomycosis, that could to interfere in the interpretation of results. * do not have skills for the application and tracking of the topical treatment with the hairspray ungual. * allergy to one of the ingredients of the nail lacquer * pregnancy or breastfeeding situation acquaintances at the time of recruitment. * use of some abrasive or cosmetic product (ej: nail paint) on the treated nail during the tracking of the study. * receiving some type of attendance podology or of pedicure out of the own ones included in the study.

Keywords: aggressive debridement nail lacquer onychomycosis podiatry chiropody podiatry care
impact of traditional chinese medicine on the gut microbiota-dependent trimethylamine n-oxide

Conditions: Acute Coronary Syndrome

Summary: recent studies highlight the participation of gut microbes in the pathogenesis of both atherosclerotic heart disease and its adverse thrombotic events. trimethylamine n-oxide (tmao) is a plasma metabolite shown to be formed through a metaorganismal pathway involving nutrient precursors abundant in a western diet and the sequential action of gut microbiota. numerous studies reveal an association between systemic tmao levels and cardiovascular risks in a variety of stable cohorts. the purpose of this study is to evaluate the efficacy of traditional chinese medicine formular (compound pseudo-ginseng granules ) on the level of tmao for the patient with acute coronary syndrome(acs) undergoing percutaneous coronary intervention. 80 patients with acs would be randomly allocated into interventional group(ig) and control group(cg). the patients in the ig would be administered by oral compound pseudo-ginseng granules (twice per day ) for 90 days and those in the cg would receive the placebo twice per day during the same period. all of subjects would be administered with standard therapy in accordance with aha/acc guideline for st-elevation myocardial infarction(stemi) and non st-elevation myocardial infarction(nstemi).the primary endpoint is the plasma level of tmao at 90-day follow-up. the second endpoint is the level of lipid, score of the seattle angina, fecal dna extraction and pyrosequencing.


Eligibility criteria:
inclusion criteria: 1. acute coronary syndrome (acs), including st segment elevate myocardial infarction(stemi), non-st-segment elevation myocardial infarction(nstemi) and unstable angina(ua). 2. tcm syndrome: intermingled phlegm and blood stasis. 3. aged 18 to 80 years old. 4. sign a consent form. exclusion criteria: 1. cardiogenic shock. 2. serious heart failure (nyha iv or lvef \< 40%). 3. with severe valvular heart disease. 4. severe hepatic or renal insufficiency, with serum alanine aminotransferase ( alt) 3 times higher than normal ceiling or serum creatinine not lower than 265 μmol/l. 5. with acute cerebrovascular disease or severe mental illness. 6. with active bleeding or severe hematopoietic system disease. 7. with malignant tumor or life expectancy in less than three years. 8. pregnancy or ready to pregnant women, nursing mothers. 9. history of taking antibiotics within the past two months. 10. participating in other clinical subjects . 11. failure to sign a consent form.

Keywords: acute coronary syndrome gut microbiota trimethylamine n-oxide percutaneous coronary intervention
brain death: inflammatory response, apoptosis, and endotoxin tolerance

Conditions: Brain Death

Summary: we hypothesized that brain death is associated with an early systemic inflammatory response, possibly combined with activation of apoptotic cell death, two events that may contribute to induce rapid organ dysfunction. in this study of brain-dead donors and controls, we assayed plasma cytokines and soluble factors, investigated plasma endotoxin levels as a triggering factor for inflammation, measured ex vivo cytokine production by blood leukocytes to determine whether immunosuppression occurred after brain death, and examined skeletal muscle biopsies to look for evidence of inflammation and increased apoptosis in peripheral tissue.


Eligibility criteria:
inclusion criteria: * all brain dead patients whatever the cause (cardiac arrest, stroke, head trauma) exclusion criteria: * age \< 18years

Keywords: brain death inflammation endotoxin transplantation graft apoptosis systemic inflammatory response apoptosis activation graft outcome
abacavir, dolutegravir and lamivudine dispersible tablets (60 mg/5 mg/30 mg)

Conditions: HIV-1-infection

Summary: the rationale for this study is to evaluate and understand the variability of a generic alternative of abacavir, dolutegravir and lamivudine dispersible tablets for pepfar submission to aide in the development of pivotal studies.

this study is to investigate the bioequivalence of mylan's abacavir, dolutegravir and lamivudine dispersible tablets, 60 mg/5 mg/30 mg to viiv's triumeq dispersible tablets (5 mg gsk1349572 \[dolutegravir\]/ 60 mg abacavir/ 30 mg lamivudine) following administration of a single, oral 60 mg/5 mg/30 mg (1 x 60 mg/5 mg/30 mg) dose of mylan's abacavir, dolutegravir and lamivudine dispersible tablets or viiv's triumeq dispersible tablets administered under fasting and fed conditions. adverse events will be monitored to ensure the safety and well-being of the healthy volunteers.

Eligibility criteria:
inclusion criteria - subject candidates must fulfill all of the following inclusion criteria to be eligible for participation in the study, unless otherwise specified: * 18 to 55 years old. * males and/or females not of child-bearing potential. * each subject is required to weigh at least 50 kg (110 lbs) for men and 48 kg (106 lbs) for women and have a body mass index (bmi) value less than or equal to 30.0 kg/m2 but greater than or equal to 19.0 kg/m2. * adequate venous access in both arms. * only non-tobacco/non-nicotine subjects. * able to understand and sign the written informed consent form. * willing to follow the protocol requirements and comply with protocol restrictions. * all subjects should be judged by the principal investigator or medical sub- investigator as normal and healthy during a pre-study medical evaluation performed within 28 days of the initial dose of study medication. exclusion criteria - subject candidates must not be enrolled in the study if subject meet any of the following criteria: * institutionalized subjects. * social habits, medications and diseases will be evaluated. * use of certain foods and processed candies, gums food/drinks that contain sugar alcohols. * liver function tests (alt, ast and total bilirubin). * subjects who are positive for the hla-b\*5701 allele. * subjects having modified patient health questionnaire (phq)-12 questionnaire score \> 4. * subject has a creatinine clearance \< 90 ml/min, as determined by the cockroft-gault equation. * any reason which, in the opinion of the principal investigator or medical sub- investigator, would prevent the subject from safely participating in the study. * intolerance to venipuncture. * donation or loss of blood or plasma. * subjects who have received an investigational drug within 30 days prior to the initial dose of study medication. * any food allergy, intolerance, restriction or special diet that, in the opinion of the principal investigator or medical sub-investigator, could contraindicate the subject's participation in this study. * allergy or hypersensitivity to abacavir, dolutegravir, lamivudine, other related products, or any inactive ingredients.
locobase® repair used as an adjunctive to standard therapy in children with moderate to severe atopic dermatitis

Conditions: Dermatitis, Atopic

Summary: to assess the efficacy of locobase repair® when used in children with moderate to severe ad


Eligibility criteria:
inclusion criteria: * has given written informed consent (parents or guardian, child if applicable) * moderate to severe ad * continuous use of topical corticosteroid or topical calcineurin inhibitor (tci) as active treatment of ad for more than 4 weeks prior to screening (no change in topical corticosteroid or tci is allowed between screening and day 1) * in the opinion of the investigator, subject is unlikely to require a significant change to his/her current treatment regimen during the study period exclusion criteria: * has infected lesions * the last assessment of any clinical study within 3 months prior to the expected date of entering into the study * current use of locobase® repair * known allergy to locobase® repair or any of its components * any clinical condition which, in the opinion of the investigator, would not allow safe completion of the study

Keywords: atopic dermatitis
evaluation of prognostic factors in tympanoplasty

Conditions: Tympanic Membrane Perforation

Summary: tympanoplasty is the surgical operation performed for the reconstruction of the eardrum and/or the ossicles. tympanoplasty is classified into five different types, originally described by horst ludwig wullstein. 1,2 type 1 involves repair of the tympanic membrane alone, when the middle ear is normal. a type 1 tympanoplasty is synonymous to myringoplasty, type 2 involves repair of the tympanic membrane and middle ear in spite of slight defects in the middle ear ossicles, type 3 when mallus and incus are absent graft place directly on stapes head., type 4 describes a repair when the stapes foot plate is movable, but the crura are missing. the resulting middle ear will only consist of the eustachian tube and hypotympanum, type 5 is a repair involving a fixed stapes footplate. there are various prognostic factors reported in the literature that may influence the surgical success of tympanoplasty.

some studies report significance for some of these factors whereas others report the contrary. the reported incidence of surgical success of tympanoplasty ranges from 60% to 99% in adults belluci described four separate stages for prognosis of tympanoplasty 4 according to otorrhea . austin proposed a prognostic stratification according to disease categories, stage categories, and disease descriptors. black introduced the surgical, prosthetic, infection, tissues, and eustachian tube system (spite), and more recently kartush developed middle ear risk index (meri). smoking is added as a middle ear risk. furthermore, cholesteatoma and granulation tissue or effusion risk value has been increased in meri 2001. prognostic factors such as age, sex, presence of systemic diseases, location and size of perforation, duration of dry period, presence of myringosclerosis, presence of septal and conchal pathology, operation type, and status of the opposite ear and middle ear risk index were investigated. 9

Eligibility criteria:
inclusion criteria: * patients of the age group 18-60 years with chronic suppurative otitis media (csom) planned for tympanoplasty. exclusion criteria: * patients with otomycosis, septic foci such as sinusitis which can influence the outcome of tympanoplasty were excluded from the study
study of the impact of everolimus treatment on lymphocytes nk (natural killer) development and functions for patients with a metastatic breast cancer (hr+ / her2/neu negative)

Conditions: Breast Cancer

Summary: nk (natural killer) cells are important in the fight against tumor, especially for the control of cancer metastasis. the purpose of this prospective study is to evaluate the impact on lymphocytes nk functions and development of an everolimus treatment in women treated for a metastatic breast cancer. in particular, the study of lymphocytes nk functions and development under everolimus treatment could permit to validate an early biomarker of the impact of everolimus on these nk cells.


Eligibility criteria:
inclusion criteria: * women \> 18 years old * metastatic breast cancer hr+ (hormone receptor positive), her2/neu negative (human epidermal growth factor receptor-2) * ecog ps (eastern cooperative oncology group performance status) ≤2 * eligible to an hormonotherapy treatment combined to an mtor (mammalian target of rapamycin) inhibitor (i.e. spc (summary of product characteristics) modalities) * measurable disease according to recist 1.1 (response evaluation criteria in solid tumors) * not receiving the non-authorized concomitant treatments * patient should understand, sign, and date the written voluntary informed consent form at the screening visit prior to any protocol-specific procedures performed. * patients must be covered by a medical insurance exclusion criteria: * bmi\>30 * all dysimmune disease, history of transplantation or immunosuppressive therapy or corticotherapy * all chronic inflammatory diseases * last chemotherapy \< 6 months * corticotherapy \<1 year and more than 1 month * restrictive diet ≤3 months before inclusion

Keywords: everolimus nk metastatic
topical tacrolimus in vernal keratoconjunctivitis

Conditions: Vernal Keratoconjunctivitis

Summary: the main aim of this study is to evaluate the efficacy and safety of topical tacrolimus 0.01% eyedrops in patients with vernal keratoconjunctivitis.

a total of 20 patients with bilateral symmetrical vernal keratoconjunctivitis will be included. each patient will undergo a complete ophthalmologic evaluation. patient will be placed at random on topical tacrolimus 0.01% ophthalmic solution in one eye and placebo eyedrops in the fellow eye. patients will undergo ophthalmologic examination at one week and after one month. photos will be taken. the outcome measures include graded symptoms, graded signs, and laboratory investigations. symptoms of itching, redness, foreign body sensation, tearing and discharge following will be recorded before and after treatment. the grading of clinical signs of conjunctival hyperemia, conjunctival papillary hypertrophy, perilimbal infiltrates, trantas dots, superficial punctate keratopathy will be recorded before and after treatment. conjunctival surface temperature will be determined before and after treatment. conjunctival scrapings will be stained with giemsa and will be assessed before and after therapy and number of eosinophils per hpf will be determined and recorded.

Eligibility criteria:
inclusion criteria: * with bilateral symmetrical palpebral and limbal vernal keratoconjunctivitis * patients 6-18 years of age exclusion criteria: * pregnant patients * patients on systemic therapy for other allergic disorders * patients who cannot come for follow-up * patients who are on other topical medications for other comorbid ocular conditions
project interact v2

Conditions: Firearm Violence; Firearm Carriage; Injury Prevention

Summary: the present study is evaluating the efficacy of a behavioral intervention to reduce risky firearm carriage among a high risk sample of youth reporting recent firearm carriage and ownership of a smartphone.

firearms are the leading cause of death for u.s. youth; 60% due to homicide. this study will test the efficacy of a behavioral intervention at reducing risky firearm behaviors among a high-risk community sample of youth (age 16-24) that report past 3-month firearm carriage and smartphone ownership. the behavioral intervention consists of 3 remotely delivered therapy sessions integrating motivational interviewing (mi), cognitive behavioral therapy (cbt), and care management (cm), supported by a smartphone app that facilitates therapist contact, conducts automated daily assessments, delivers between session tailored therapy content, delivers just-in-time global positioning system (gps)-triggered notifications upon entry into high-risk locations, and aids with utilization of local resources. recruitment will proceed in two high-risk communities (flint, saginaw), including through the main emergency departments/trauma centers that are located in both cities. given elevated rates of firearm violence among socio-disadvantaged youth with disparities in access to community services, the proposed intervention, if found to be efficacious, has the potential for significant public health impact.

Eligibility criteria:
inclusion criteria: * flint or saginaw youth between the ages of 16 to 30 reporting past 3-month firearm carriage and ownership of a smartphone, including those seeking care for any reason at hurley medical center or covenant medical center emergency department. * can provide consent (age: 18-30) or youth assent and parental consent (age: 16-17) for the study. exclusion criteria: * incarcerated (i.e., in active policy custody and not able to provide informed consent) * presenting to the ed for active suicide ideation or attempt, sexual assault, and/or child abuse * unable to provide informed consent due to mental status (e.g., alcohol intoxication, acute psychosis) or medical instability. * participants will be excluded if firearm carriage is exclusively for legal work (e.g., police), hunting, or target shooting.

Keywords: emergency department
early identification of brain insult in chorioamnionitis

Conditions: Chorioamnionitis; Cerebral Palsy

Summary: premature breaking of the amniotic fluids during pregnancy caries high risk for infection of the amniotic fluid. one of the results of chorioamnionitis is brain injury of the fetus. fetus' brain is highly vulnerable and could be harmed even by mild inflammation before fulminant infection is developed. the aim of this study is to identify, as early as, possible signs of brain injury. s100b protein will be used as a marker for brain insult. s100b level were associated with the occurrence and size of stroke and brain trauma in adults and children. moreover, s100b crosses the membrane and its level in women with preterm labor was associated with brain injury of preterm infant. the study question is whether the levels of s100b in women with early amniotic fluids breakdown are associated with future brain injury of the infant, as assessed by head ultrasound and neurological examination.


Eligibility criteria:
inclusion criteria: * rupture of the amniotic sac before 32 weeks * gestational age less than 32 weeks * singleton exclusion criteria: * intrauterine growth restriction * positive torch * fetus' brain malformation * fetus' brain hemorrhage * maternal medication with teratogenic effect

Keywords: chorioamnionitis, s100b, brain, neuro-development