Kornimate/medical-research-clean huggingface dataset:
sedation, temperature and pressure after cardiac arrest and resuscitation

Conditions: Cardiac Arrest With Successful Resuscitation; Hypoxia, Brain

Summary: the stepcare-trial is a 2x2x2 randomised trial studying patients who have been resuscitated from cardiac arrest and who are comatose. it will include three different interventions focusing on sedation targets, temperature targets and mean arterial pressure targets.

3500 patients who are comatose after cardiac arrest will be included in a trial studying three separate targets. all patients will be randomised to a control or an intervention arm for sedation, temperature and blood pressure targets. these are. 1. continuous deep sedation for 36 hours or minimal sedation (sedcare) 2. fever management with or without a feedback-controlled device (tempcare) 3. a mean arterial pressure target of \>85mmhg or \>65mmhg. (mapcare) participants will be followed up at 30 days and 6 months. the primary outcome will be survival at 6 months.

Eligibility criteria:
inclusion criteria: 1. out-of-hospital cardiac arrest 2. sustained rosc - defined as 20 minutes with signs of circulation without the need for chest compressions 3. unconsciousness defined as not being able to obey verbal commands (four-score motor response of \<4) or being intubated and sedated because of agitation after sustained rosc. 4. eligible for intensive care without restrictions or limitations 5. inclusion within 4 hours of rosc exclusion criteria: 1. on ecmo prior to randomization 2. pregnancy 3. suspected or confirmed intracranial hemorrhage 4. previously randomized in the stepcare trial.
effect of a website offering individual patients' experiences for cancer patients

Conditions: Colorectal Cancer

Summary: being diagnosed with cancer confronts patients with a severe disease and they need to learn to deal with a range of new challenges. in order to support patients in the coping process, the website www.krankheitserfahrungen.de provides patients free, reliable information about health issues by sharing peoples' real-life experiences. in our project, the investigators developed a new module on the website for patients with colorectal cancer. the objective of our study is to evaluate if access to the new colorectal cancer module on the website www.krankheitserfahrungen.de increases patient's competence. the investigators will conduct a two-arm randomized controlled trial. patients affected by colorectal cancer will be randomized into an intervention and a control group: the intervention group will have access for two weeks to the website www.krankheitserfahrungen.de (colorectal cancer module) with cancer patients´ experiences. patients in the control group will not receive any intervention but will have access to the website for two weeks after completing the study. patient competence is measured by the self-efficacy component of the german short form of the cancer behavior inventory via an online questionnaire at baseline and after two weeks. a second follow-up assessment will be implemented six weeks after baseline.


Eligibility criteria:
inclusion criteria: * patients diagnosed with colorectal cancer within the last 3 years or with metastases or relapse after colorectal cancer * having access to internet exclusion criteria: * patients diagnosed with colorectal cancer more than 3 years ago and without metastases or relapse
metabolic study of concentric and eccentric muscle training

Conditions: Lipid Metabolism; Insulin Resistance; Inflammation

Summary: the purpose of this study is to evaluate the metabolic and anti-inflammatory effects of eccentric endurance exercise and to compare them with those of concentric exercise in healthy sedentary individuals.

physical exercise decreases the risk of obesity, diabetes mellitus, and cardiovascular disease. skeletal muscle can be exercised by two ways: concentric contraction is defined as active shortening of muscles, e.g. by stepping upwards, whereas eccentric muscle contraction is defined as active resistance to stretching, e.g. by stepping downwards. although the effects of exercise (i.e. the combination of concentric and eccentric muscle contraction) on metabolic parameters have been extensively investigated, there are no data on the specific metabolic effects of concentric versus those of eccentric muscle work in humans. comparison(s): metabolic and anti-inflammatory effects of eccentric endurance exercise (i.e. stepping upwards), compared to metabolic and anti-inflammatory effects of concentric exercise (i.e. stepping downwards).

Eligibility criteria:
inclusion criteria: * healthy men and women * age over 30 years exclusion criteria: * previous systematic endurance training (≥3 times per week ≥30 min) * body mass index \>30 kg/m2 * heavy smoking (\>20 cigarettes per day) * regular alcohol consumption \>60g per day * established musculoskeletal disease * history of cardiovascular disease * diabetes mellitus * unwillingness to stay in the area for the whole study period

Keywords: exercise lipid metabolism lipoproteins insulin resistance inflammation
dexmedetomidine in obturator nerve block as an analgesic in transurethral surgeries

Conditions: Dexmedetomidine

Summary: in our study, we will investigate the impact of adding dexmedetomidine to bupivacaine for the potency of the obturator nerve block and prevention of the postoperative pain associated with transurethral surgery in comparison of obturator nerve block with bupivacaine alone

* after history taking and examination of the labs and airway of the patient , an intravenous catheter will be secured in the dorsum of the hand of non dominant hand and patients will be monitored for heart rate, noninvasive blood pressure, and oxygen saturation. * all patients after aseptic preparation will receive subarachnoid block in lumber 3-4 or 4-5 space in sitting position. * about 3 ml (15mg) of heavy 0.5% bupivacaine will be injected into subarachnoid space. * after the completion of the block, patients will be laid in the supine position and subsequently waited for 5 min for fixation of drug and assessed for sensorimotor block. * further procedure will be performed as per the group allocation. * onb will be performed by classic technique 1.5cm lateral and 1.5cm caudal to the pubic tuberacle . after contact with the pubic ramus is made , the needle is redirected laterally to a point 2-3 cm deeper than the pubic ramus.(15) * a waiting period 20 min will be allowed for the full effect of the block and then resection will be allowed to perform * hemodynamics (heart rate, mean arterial blood pressure) will be recorded intraoperatively and postoperative at 0, 2 and 6 hours . * vas score at 0,2 and 6 hours post-operatively will be assessed. * time to first call for analgesic requirements (duration of analgesia) will be measured. * total postoperative analgesic consumption in the first 24 hours post-operative will be measured. * incidence of complications such as nerve injury, hematoma formation, local anesthetic toxicity, intravascular injection, bleeding and bladder perforation will be assessed.

Eligibility criteria:
inclusion criteria: * participants will be adults (above 18 years) scheduled to undergo transurethral surgery under regional anesthesia. * asa1, asa2 exclusion criteria: * american society of anesthesiologists (asa) physical class 3,4, severe cardiac comorbidity (impaired contractility with ejection fraction less than 50%, heart block, significant arrhythmias, tight valvular lesions), allergy to any study's drugs

Keywords: obturator nerve block dexmedetomidine
molecular assessment for gastro-esophageal cancer

Conditions: Esophageal Cancer; Gastric Cancer; Barrett Esophagus

Summary: the goal of this minimally invasive interventional study is to learn if oncometabolic biomarkers, detected in the exhaled breath and blood can identify early-stage gastro-oesophageal cancer in patient at risk for gastro-oesophageal cancer. the main questions this study aims to answer: are oncometabolites proficient and reproducible enough to function as diagnostic biomarkers? can these biomarkers identify early-stage gastro-esophageal cancer? researchers will compare participants with gastro-oesophageal cancer to healthy controls and participants with barrett's esophagus to detect meaningful differences between the groups. participants will provide a breath and blood sample during their routine standard of care visits.


Eligibility criteria:
inclusion criteria: 1. voluntary written informed consent of the participant or their legally authorized representative has been obtained prior to any breath or blood analysis 2. \>18 years old 3. barrett's esophagus or treatment naïve gastro-esophageal cancer stage i to iv 4. voluntary healthy controls exclusion criteria: 1. \<18 years old 2. patient has history of: 1. active other cancer than gastro-esophageal cancer 2. prior cancer treated \<3 years ago 3. hepatic dysfunction/liver failure (melt \>7) 3. any disorder, which in the investigator's opinion might jeopardise participant's safety or compliance with the study plan. 4. insufficient/unreliable quality of breath (e.g., breath flow) or plasma sample (e.g., haemolytic sample) 5. incarcerated individuals

Keywords: oncometabolites early-stage cancer diagnostic testing screening
effects of a patient driven assessment process with complex pain patients

Conditions: Chronic Pain

Summary: the objective of this study is to engage patients with chronic pain and other key stakeholders in an iterative process of pilot-testing a validated patient generated instrument, the measure yourself medical outcome profile (mymop), to support primary care encounters and provide a direct comparison between a strategy of incorporating patient reported outcomes into the package of care for complex pain patients and usual care. the specific aims of this phase of the project are to: 1) adapt the mymop for use in the primary care setting well-integrated into everyday practice flow, and 2) evaluate whether the utilization of the mymop data in routine primary care encounters results in improvements in patient symptoms and functioning over time as well as increased satisfaction with the visit for patients and primary care providers. to achieve aim 2, the investigators will compare the reported outcomes and health care utilization from participating patients in this study for whom the mymop-based instrument will be used in routine clinical care to a matched group of chronic pain patients who will not receive the mymop-based assessment but will otherwise have similarly collected data. this also allows us to evaluate of the extent to which use of the tool adds patient-centered information to more conventional instruments. in addition to these two aims, for a third aim, the investigators plan to collect qualitative data from patients, their family members, kaiser permanente northwest (kpnw) health care providers, and kpnw administrators to better understand the needs of this subpopulation of patients.


Eligibility criteria:
inclusion criteria: * 18 years or older * kaiser permanente northwest health plan members with at least 12 months of continuous eligibility at time of study entry and receive primary care from participating physicians * continued opioid use during the previous 6 months, as defined by 2 or more dispenses of long-acting opioids and/or a minimum cumulative supply of 90 days' worth of short-acting opioids based on electronic medical record (emr) d) emr recorded diagnosis of nonspecific chronic pain, fibromyalgia, or diagnosis of ≥ 2 types of pain in the past year exclusion criteria: * active cancer * substance abuse or dependence * hospice care * severe mental illness

Keywords: chronic pain analgesics, opioid primary health care
perioperative analgesia in neonates who underwent primary cleft lip repair surgery

Conditions: Perioperative Analgesia in Neonates

Summary: in retrospective data search the investigators will identified the cumulative consumption of opioid analgesics during surgery and 24 hours after surgery in neonate with cleft lips who underwent primary cleft lip repair surgery.

the cumulative consumption of opioids during surgery and 24 hours after surgery in neonates with cleft lips who underwent primary cleft lip repair surgery is not known. patients were divided into two groups according to the time period when they underwent surgery. group 1 were neonates who underwent primary cleft lip repair surgery under general anaesthesia without regional anaesthesia - the time period before regional anesthesia is introduced into the standard procedure. group 2 are newborns who underwent primary cleft lip repair surgery under general anaesthesia with regional anaesthesia. group 1 underwent surgery in time period before regional anesthesia was introduced into the standard procedure. in this retrospective study, the anesthesiology perioperative data from january 2018 till december 2021 in the tertiary center of pediatric anaesthesia will be evaluated.

Eligibility criteria:
inclusion criteria: * neonates with unilateral or bilateral cleft lip (u/bcl), all neonates with unilateral or bilateral cleft lip and alveolus (u/bcla) or with unilateral or bilateral cleft lip, alveolus and palate (total cleft; u/bclap) who underwent cleft lip repair surgery in the neonatal period * the study period (1/2018-12/2021) exclusion criteria: * ● presence of coagulopathy * thrombocytopenia or thrombopathy * patients at risk of malignant hyperthermia * patients who were not neonates (older than 28 days) * patients who required postoperative mechanical ventilation

Keywords: perioperative analgesia primary cleft lip repair surgery infraorbital peripheral blockade
turmeric gel as alternative non-vital pulpotomy medicament in primary teeth

Conditions: Non-Vital Tooth

Summary: the purpose of this randomized controlled clinical trial is to use turmeric gel as non-vital pulpotomy medicament compared to formocresol in primary teeth by evaluating its antibacterial effect against streptococcus mutans and lactobacillus acidophilus. it is hypothesized that there is no difference in the antibacterial effect of turmeric gel compared with formocresol, when used as non-vital pulpotomy medicaments.

it is a multi-arm parallel randomized controlled trial in which forty patients aged between 4 to 8 years, each containing at-least one non-vital primary molar, will be selected and randomly divided into group a (formocresol) and group b (turmeric gel). non-vital pulpotomy will be performed by removing the coronal necrotic pulp. sterile paper point will be dipped in the root canals and taken to the laboratory. cotton pellets soaked in the respective medicaments will be placed over the root canal orifices and filled temporarily. patients will be recalled after one week. samples will be again taken, and tooth restored. comparison between bacterial count at baseline and after one week of treatment will be made and expressed as colony-forming units/ml (cfu/ml).

Eligibility criteria:
inclusion criteria: 1. cooperation of patients and consent of parents. 2. patients with asa classification i and ii (mild to moderate systemic disease). 3. non-traumatic extensively carious hence restorable primary molars. 4. no history of antibiotic use for 2 weeks. 5. presence of following clinical signs or symptoms suggestive of non-vital tooth such as tenderness on percussion, non-responsive to cold test, periapical/furcal radiolucency, localized gingival/mucosal soreness/ redness/ swelling, and/or slight mobility-grade i. exclusion criteria: 1. history of allergy to anesthetics and latex. 2. radiographic evidence of pulpal floor opening into the furcation area. 3. more than half of the roots resorbed.
effect of improved indoor lighting on residents of residential care homes with dementia

Conditions: Dementia

Summary: elderly with dementia living in residential care homes often have limited access to adequate lighting (daylight). light can however positively impact the individual on a number of factors, including sleep quality and mental health. the proposed non-invasive study seeks to evaluate the impact of an improved lighting environment in the living areas of residential care home residents with dementia on both the physical and mental well-being of these individuals. to assess sleep quality, an actigraphy device will be used from which a number of parameters corresponding to sleep quality can be obtained. mental health/behaviour of the participants will be assessed by validated questionnaires. these questionnaires will be filled for each participant independently by 2 members of the nursing staff. two groups of residential care home residents will be observed during this study: an intervention group and a control group. in the intervention group, innovative lighting designs are already implemented in the living area. the control group will experience no significant modifications to their lighting conditions. extra luminaires (floor lamp/table lamp) will be employed without significantly improving the light exposure during the day. it is hypothesized that the introduction of enhanced lighting during the day in the living area of the intervention group will result in improved sleep quality and enhanced mental well-being.


Eligibility criteria:
inclusion criteria: 1. diagnosed with dementia 2. residing in the selected living area exclusion criteria: 1. blind individuals 2. not residing in the selected living area 3. not diagnosed with dementia

Keywords: lighting integrative lighting dementia nursing home residential care home
can total mechanical power be a determinant of weaning failure in chronic obstructive pulmonary disease (copd)?

Conditions: COPD (Chronic Obstructive Pulmonary Disease); ARDS (Acute Respiratory Distress Syndrome); Mechanical Power; Pneumonia; Weaning Failure

Summary: a comparison of ventilator parameters (tv, dp, total mechanical power, etc.) between successfully and unsuccessfully weaned patients with copd undergoing mechanical ventilation due to respiratory failure, and diagnosed with pneumonia or ards in the intensive care unit."

the objective of this study is to investigate which mechanical ventilation parameters and clinical findings influence weaning success by comparing successful and unsuccessful weaning patient groups among patients diagnosed with copd who were intubated and monitored for more than five days in the intensive care unit. the findings of this study may contribute to the development of future treatment protocols and criteria for evaluating the weaning process. this study is planned to be conducted in two centers: bakırköy dr. sadi konuk training and research hospital in istanbul and shahid beheshti university of medical sciences, masih daneshvari hospital in tehran. this multicenter study aims to facilitate the comparison of data obtained under different geographical and clinical conditions, thereby enabling a broader analysis of factors influencing the weaning process across a larger patient population.

Eligibility criteria:
inclusion criteria: * patients aged 18 years and older * copd-diagnosed patients who have been intubated and stayed in the icu for more than 5 days exclusion criteria: * patients without electronic medical records * patients under 18 years of age * patients diagnosed with pulmonary malignancy * patients who stayed in the icu for less than 5 days * patients monitored in the icu without intubation

Keywords: mechanical power copd
do pa interventions increase acute medical inpatients pa levels

Conditions: Physical Activity; Moving Medicine; Acute Medical Unit

Summary: physical activity (pa) can help treat and prevent many physical and mental health conditions. however, many of the united kingdom population do not meet the department of health's pa recommendations which is contributing to the high chronic disease burden in the uk population. many patients who are admitted to acute medical wards have at least one co- morbidity. inpatients on acute hospital wards do not routinely receive pa advice from healthcare staff. the investigators believe that patients could be encouraged to increase their pa level (pal) during an admission to hospital.

the investigators have undertaken two previous qualitative studies that proceed this work. the first study found that patients were open to discussing pa during admission to an acute medical unit (amu). in the second study patients thought motivational interviews focused on pa helped them increase their pal. although patients have reported that motivational interviews were beneficial in helping them increase their pa, this has so far not been assessed quantitatively. the investigators plan to recruit 50-100 patients and randomise them into two groups. one group will receive a short pa intervention and the other a long intervention. the investigators will use the moving medicine online resource to structure both pa intervention. the 'one minute' conversation will be used for the short pa intervention and the 'more minutes' conversation for the long pa intervention. the investigators will measure the pal of both groups at baseline and at two follow-up points (4 weeks and 12 weeks). the global physical activity questionnaire will be used to assess participants self-reported pal. the data collected will be used to describe participants baseline pal and the treatment effect of the two pa interventions. the investigators will also calculate estimated recruitment and retention rates. the results of this feasibility study will be used to plan a similarly designed powered randomised controlled trial.

Eligibility criteria:
inclusion criteria: * ability to give informed consent. * patients equal or greater than 18 years of age. * patients identified by ward staff as being about to be discharged from hospital over the coming day(s). * patients identified by ward staff as being able to walk 10m on flat ground, with or without a walking aid. exclusion criteria: * patients who do not understand verbal and written english. * patients who currently meet the department of health's current aerobic physical activity recommendations as assessed by the gpaq.