Kornimate/medical-research-clean huggingface dataset:
local lidocaine infiltration for pain management post cesarean delivery.

Conditions: Pain; Cesarean Delivery

Summary: the objective of this prospective, double-blinded, placebo-controlled, randomized study is to evaluate the impact of preemptive analgesia using incisional site infiltration of lidocaine as compared to saline solution on post operative pain control in women undergoing cesarean deliveries.

the studied population would be based on women who are scheduled for an elective cesarean delivery under general/spinal analgesia using a transverse lower abdominal incision. prior to each operation, the surgeon will be provided with a syringe containing a 20 ml solution of 1% lidocaine or 0.9% sodium chloride, which will be injected subcutaneously to the incisional site region after anesthesia and before the beginning of the surgery. after the operation the conventional post cesarean analgesic regime will be used and recorded for all women. the self-report of pain will be assessed by the patient using a validated visual analog scale, as instructed by the nursing staff. the patient's mark will be used as a numerical index of pain intensity. the reports will be taken by the patients in intervals of 4 hours for 48 hours after the operation. in addition, analgesic requirements of the patient will be monitored and recorded by the nursing staff and used for comparison between the two study group

Eligibility criteria:
inclusion criteria: * women who are scheduled for an elective cesarean delivery under general/spinal analgesia using a transverse lower abdominal incision. exclusion criteria: * more than two previous cesarean deliveries * other abdominal operations in the past * morbid obesity * diabetes mellitus, neurological diseases, systemic vascular disease. * mental disability * lidocaine sensitivity

Keywords: management post
correlation between δpp/hr and δsv during fluid challenge.

Conditions: Hypovolemia

Summary: in high perioperative risk patients, guidelines suggest intraoperative haemodynamic optimization by measurement of stroke volume (sv) to guide fluid resucitation.this strategy requires an invasive monitoring and learning. some studies tried to find sv surrogates based on haemodynamic usual parameters. in an experimental hemorrhagic shock, sv was correlated to the pulse pressure (pp) / heart rate (hr) ratio. the investigators hypothesized that sv variations (δsv) would be correlated to the pp/hr ratio variations (δpp / hr) during fluid challenge, and δpp / hr would be able to detect a δsv greater than 10%.


Eligibility criteria:
inclusion criteria: * a suspected hypovolemia, based on clinical or paraclinical parameters. * a fluid challenge decision at the discretion of the anaesthesiologist physician in charge of the patient. exclusion criteria: * minor or major patient under guardianship, * oesophageal diseases

Keywords: stroke volume, haemodynamic, fluid resucitation
the effect of blood transfusion on endothelial function

Conditions: MDS; Anemia

Summary: blood transfusion is often used to treat patients with anemia. the period of storage of blood products prior to use for transfusion may vary. prolonged storage of blood products may result in changing their biochemistry. this study aims to look into whether the transfusion of "old" blood, which is stored for more than 7 days, as compared to the transfusion of "fresh" blood, which is stored for less than 7 days, will affect endothelial function.

endothelial function assessed pre and post transfusion. the endopat uses a unique bio-sensors that are placed on the fingertips to measure pressure. the test takes about 20-25 minutes. during the procedure the participant will have biosensors placed on the index finger of each hand. the nondominant arm will have a blood pressure cuff applied with sufficient pressure for five minutes. at the end of the test the device will provide a reading that assesses the level of endothelial function/dysfunction.

Eligibility criteria:
inclusion criteria: * age is \> 18 years * need recurrent blood transfusion exclusion criteria: * latex allergy * life expectancy is less than 6 months * history or evidence of drug or alcohol abuse in the last 12 months * any medical condition that will place the participant at a higher risk if they participate in the study

Keywords: blood transfusion storage lesion endothelial dysfunction nitric oxide
study to determine if tissue scored with a scalpel results in any noticeable marks

Conditions: Skin Cancer

Summary: mohs micrographic surgery is a well established method for treatment of cutaneous malignancies. part of this technique requires marking skin surrounding the tumor. there are two ways of marking the tissue, lightly scoring it with a scalpel or marking it with a surgical marker. this study is to determine if there is a noticeable difference in outcome between patients who have their tissue lightly scored with a scalpel or marked with a surgical marking pen.

mohs micrographic surgery is a well established method utilizing microscopic margin controlled excision for treatment of cutaneous malignancies (see appendix a). it has the highest cure rate of any of the methods used to treat common cutaneous malignancies and is a proven safe outpatient procedure. part of the technique requires marking skin surrounding the tumor to correspond with tissue that has been removed and divided into pieces for processing and microscopic examination. currently there are two established ways of marking the tissue; lightly scoring it with a scalpel or marking it with a surgical marker. scoring tissue is faster, more accurate, and there is no risk of having the marking washed or rubbed away.

Eligibility criteria:
inclusion criteria: * patients who are able to legally consent to study and are scheduled for mohs micrographic surgery to remove their malignancies exclusion criteria: * patients who are unable to legally consent themselves, do not wish to participate or who are not scheduled to undergo mohs micrographic surgery. * children, those with mental handicaps, pregnant women, prisoners, those with cognitive impairments, and life-threatening diseases will be excluded.
efficacy and safety of green tea polyphenol in de novo parkinson's disease patients

Conditions: Parkinson's Disease

Summary: the purpose of this study is to determine whether green tea polyphenol, an extraction from green tea is effective and safe in the treatment of de novo parkinson's disease patients without taking any antiparkinsonism drug

the primary outcome measurement is updrs using a delay start design. total 480 de novo pd patients divided into three dosage groups of green tea polyphenol and one placebo control group. patients will be treated for one year.

Eligibility criteria:
inclusion criteria: * willing and able to give informed consent * age 30 years or older at time of diagnosis of parkinson's disease * diagnosed as having typical pd * parkinson's disease duration of no more than 5 years * no current dopaminergic or other forms of anti-parkinsonism therapy * hoehn and yahr stage \< 3

Keywords: health food; green tea; neuroprotection
prophylactic ncpap in the pacu following elective laparotomy for bowel surgery

Conditions: Postoperative Pulmonary Atelectasis; Surgery

Summary: the purpose of this study is to determine whether prophylactic nasal continuous positive airway pressure (ncpap) in the post-anaesthesia care unit (pacu) improves post-operative pulmonary function following elective bowel surgery. the investigators hypothesize that one hour of ncpap in the pacu will result in a higher partial pressure of arterial oxygen (pao2) when compared to the standard treatment of low flow oxygen applied by face mask.

post-operative pulmonary complications, such as hypoxemia, pneumonia and respiratory failure, occur in 5-10% of patients following abdominal surgery. these post-operative pulmonary complications result in increased morbidity, mortality, icu admission, length of hospital stay and resource use. cpap has shown to be an effective treatment for hypoxemia following abdominal surgery. it decreases atelectasis formation the risk of pneumonia. application of ncpap to treat hypoxemic respiratory failure following thoraco-abdominal surgery has shown to decrease endotracheal intubation. nasal cpap has shown to be effective prophylaxis following elective cardiac and thoraco-abdominal aortic surgery. it reduces the incidence of hypoxemia, pneumonia, re-intubation and re-admission to the icu. it has also shown to decrease the length of hospital stay. the use of ncpap immediately post-operatively in the pacu following abdominal surgery has not been evaluated. nasal cpap is better tolerated than full face mask cpap. it allows for effective clearance of respiratory secretions, improved communication and decreases claustrophobic sensation. the pacu is a transition period from general anaesthesia into the post-operative recovery phase. during this time, residual anaesthetic causes decreased level of consciousness and sub-optimal respiratory effort. reversal agent for neuromuscular blockade has often not reached its peak effect. inadequate pain control may further decrease respiratory effort. this transition period may be when maximal atelectasis of alveolar lung units occurs. this time period may be optimal for the application of ncpap for prophylaxis against hypoxemia. it may improve post-operative pulmonary function which could decrease post-operative morbidity, mortality, length of hospital stay and resource use.

Eligibility criteria:
inclusion criteria: * patients scheduled to undergo laparotomy for elective bowel surgery exclusion criteria: * age \< 18 years * postoperative admission to the intensive care unit * a history of allergy/intolerance to ametop
fraction of inspired oxygen and atelectasis in children

Conditions: Pulmonary Atelectasis

Summary: investigators hypothesized that maintaining low fraction of inspired oxygen would be beneficial to prevent anesthesia-induced atelectasis in mechanically ventilated children undergoing general anesthesia.


Eligibility criteria:
inclusion criteria: * expected operation time between 1 to 3 hours under general anesthesia * mechanically ventilated after endotracheal intubation exclusion criteria: * cardiac, thoracic, abdominal surgery * history of surgery on the lungs * laparoscopic surgery * abnormal preoperative chest radiograph findings including atelectasis, pneumothorax, pleural effusion, and pneumonia * considered inappropriate by the investigator

Keywords: ultrasonography child perioperative period general anesthesia lung
clinical study on 5-aminolevulinic acid hydrochloride (5-ala) for fluorescence-guided resection of malignant gliomas

Conditions: Brain Neoplasm

Summary: this study is planned to detect a dose-efficacy relationship between the chosen dose levels of mc506/1 and the extent and quality of fluorescence in the tumour core in patients with newly diagnosed malignant glioma.


Eligibility criteria:
inclusion criteria: * radiological suspicion of a malignant glioma with distinct ring- or garland shaped, contrast agent-enhancing tumour structures and a core area of reduced intensity in the mri (tumour necrosis) * indication for surgical tumour resection * first operation of the tumour, no other tumour-specific pre-treatment * karnofsky performance scale 70% * patient's written informed consent * age 18-75 years exclusion criteria: * porphyria, hypersensitivity to porphyrins * renal insufficiency: * creatinine \> 2.0 mg/dl * hepatic insufficiency: * bilirubin \> 3 mg/dl * quick test \< 60 % * gt \> 100 u/i * other known malignancy (except basaliomas) women: * existing/planned pregnancy (to be checked by a pregnancy test if of child-bearing age)/lactation or inadequate contraception (hormone cycle regulation pill or condom) men: * inadequate contraception (condom) * dementia or mental condition making it impossible to understand the therapy and therefore prohibiting written consent * simultaneous participation or participation in another clinical trial in the preceding 30 days
noninvasive, subharmonic intra-cardiac pressure measurement

Conditions: Cardiac Catheterization; Blood Pressure; Heart Ventricles; Echocardiography; Heart Failure

Summary: the fundamental hypothesis of this project is that real-time intracardiac pressures can be monitored and quantified noninvasively in humans using a novel contrast-enhanced ultrasound technique called subharmonic-aided pressure estimation (shape).this study will use contrast echocardiography to assess the accuracy of shape compared to simultaneously acquired intracardiac pressures measured invasively during cardiac catheterization. this study is designed to verify that contrast echocardiography using the shape method, already proven in a canine model and tested in a human pilot study can be used as a surrogate for cardiac catheterization with sufficient accuracy to allow clinical applicability in humans.


Eligibility criteria:
inclusion criteria: * be scheduled for a cardiac catheterization procedure * adult patients over the age of 21 * acceptable baseline echocardiographic images in the supine position * if a female of child-bearing potential, must have a negative pregnancy test * provide written informed consent exclusion criteria: * clinically unstable patients, e.g., those who are clinically in decompensated heart failure or having active chest pain or presenting for admission with an unstable anginal syndrome * patients in whom introduction of a catheter into the left ventricle is contraindicated or would potentially be dangerous, e.g., patients with active ventricular arrhythmias or with significant aortic valve stenosis where crossing the aortic valve may be difficult and not clinically necessary * patients with anatomic right-to-left, bi-directional, or transient right-to-left cardiac shunts where definity could traverse as a bolus * patients with known hypersensitivity to definity * females who are pregnant or nursing

Keywords: pressure measurements blood pressure contrast echocardiography ventricular pressures catheterization
chemokine receptor cxcr4-targeting molecular imaging for metabolic characterization of multiple myeloma and lymphoma

Conditions: Multiple Myeloma; Lymphoma

Summary: chemokine receptor cxcr4 was expressed in mm and lymphoma cells and cxcr4-targeting molecular imaging- 68ga-pentixafor pet/ct could be a promising technique to evaluate the extent of mm and lymphoma with higher accuracy. this prospective study is going to investigate whether metabolic characterization by 68ga-pentixafor pet/ct may be superior for diagnosis, risk stratification, and prognostic evaluation of mm and lymphoma.

multiple myeloma: multiple myeloma (mm) is characterized by the neoplastic proliferation of plasma cells producing a monoclonal immunoglobulin. the durie and salmon and iss clinical staging system have been well-accepted as a practical way to evaluate mm tumor burden nowadays. but it is difficult to assess the accurate tumor involvement because of the significant heterogeneity characterizing this disease at multiple levels such as clinical presentation, biologic characteristics, treatment response, and clinical outcome. new imaging modalities such as 18f-fdg pet/ct has been used to improve the efficacy of this system in assessing the extent and severity of mm, but the diagnostic accuracy of 18f-fdg pet/ct decreased in lower proliferative mm cells and inflammation. recent studies showed chemokine receptor cxcr4 was expressed in mm cells and cxcr4-targeting molecular imaging- 68ga-pentixafor pet/ct could be a promising technique to evaluate the extent of mm with higher accuracy. this prospective study is going to investigate whether metabolic characterization by 68ga-pentixafor pet/ct may be superior for diagnosis, risk stratification, and prognostic evaluation of mm. lymphoma: lymphoma is a frequent cancer with high cxcr4 expression. according to the previous studies, 68ga-pentixafor-pet seems to be a highly selective and specific method for the in vivo quantification of cxcr4 expression. thus our study is going to investigate the value of 68ga-pentixafor-pet/ct for the diagnosis，differentiation and pretherapeutic evaluation of cxcr4 expression in lymphoma.

Eligibility criteria:
inclusion criteria： * suspected or confirmed untreated mm or lymphoma patients * 18f-fdg pet/ct within two weeks * signed written consent. exclusion criteria: * pregnancy * breastfeeding * known allergy against pentixafor * any medical condition that in the opinion of the investigator,may significantly interfere with study compliance.
memorisation of phonologic information among children with oral language developement disorder

Conditions: Language Development Disorders

Summary: the disorder of oral language development is defined by the delay in language acquisition in children who possess efficient auditory acuity and normal non verbal intellect. the diversity of language developement disorders depends either in the expressive level or in the receptive level leading to divers syndromes and symptoms. these syndromes and symptoms are regrouped under the name of stol (specific troubles of oral language). in the current project the visual exploitation and learning capability of children presenting a stol condition will be compared to patients with a normal development. the investigator's hypothesis is as follows: stol patients for whom the stol disorder is reduced between 4 and 7 years of age will present a better performance at verbal memorisation, compared to patients with a persistent stol condition after the age of 6.


Eligibility criteria:
inclusion criteria for stol patients: * child aged between 45 and 95 months at inclusion * a score \> or equal to 5 percentile on the non verbal intelligence test (pm47) * patient diagnosed with stol by the neuropediatric medical team * coverage of the social insurance * consent form signed by the parents or the legal representative of the child * normal or corrected sight * normal hearing inclusion criteria for control patients: * child aged between 45 and 95 months on the day of inclusion * a score \> or equal to 5 percentile on the non verbal intelligence test (pm47) * child who did not receive any speech therapy * coverage of the social insurance * consent form signed by the parents or the legal representative of the child * normal or corrected sight * normal hearing exclusion criteria for stol patients: * mother language other than french * score \< to 5 percentile on the non verbal intelligence test (pm47) * child with pervasive developmental disorder exclusion criteria for control patients: * mother language other than french * score \< to 5 percentile on the non verbal intelligence test (pm47) * child who received speech therapy

Keywords: oral language stol memory eye tracking
improving antibiotic use for aris in urgent care clinics

Conditions: Antibacterial Agents; Ambulatory Care

Summary: many clinicians prescribe antibiotics for patients with acute respiratory infections even when antibiotics will not benefit the patient because the infection is due to a virus. to discourage this type of unnecessary antibiotic use, the investigators will assess whether it is helpful to give clinicians feedback on how often they prescribe antibiotics for respiratory infections in comparison to their peers. the investigators will perform this study across urgent care and quickcare clinics within a single healthcare system.

the investigators have used an established hedis (healthcare effectiveness data and information set) metric to evaluate urgent care and quickcare clinicians on their antibiotic use for respiratory tract diagnoses (rtds). this rtd metric excludes visits that are more complicated, based on well-defined criteria. based on our baseline assessment (2018-2022), the investigators estimate that most clinicians in this setting are frequently prescribing unnecessary antibiotics. the investigators will perform a randomized controlled trial to assess whether providing individualized feedback to clinicians on the rtd metric can safely reduce antibiotic use for qualifying respiratory tract visits across urgent and quickcare settings within a single integrated healthcare system. clinicians who do not opt-out of the trial will be randomized to either receive feedback or not receive feedback on this rtd metric. the trial will last for 18 months. the primary outcome of effectiveness will be the frequency of antibiotic-prescribing for rtd visits. secondary outcomes include total antibiotic use (regardless of diagnosis), changes in the use of diagnostic codes, 30-day rates of follow-up visits and hospital admissions. the re-aim framework will be used to guide additional study evaluation.

Eligibility criteria:
any clinician who works in urgent care or quickcare clinics within our healthcare system.
metal ion levels in stryker trident ii tritanium system with modular dual mobility (mdm) liner, ceramic head, and securfit advanced stems

Conditions: Hip Pain

Summary: metal ions levels of cobalt, chromium, and titanium in 40 patients preoperatively and at least 1 year status post total hip replacement with the trident ii tritatnium system using an mdm liner and ceramic head. are cobalt, chromium, and titanium levels in patients who undergo a total hip replacement with a trident ii tritanium system, mdm liner, and ceramic head normal one year after surgery? investigators expect to find normal levels of metal ions (cobalt, chromium, and titanium) after total hip replacement using trident ii tritanium cups with an mdm liner and a ceramic head. the primary outcome (po) is blood metal ion levels of cobalt, chromium, and titanium (concentration of metal ions in blood). blood will be drawn in the 3rd floor west of the main building, and then tested for metal ions in the hospital for special surgery laboratory. the bloods will be drawn at a preoperative visit and at a one year visit.


Eligibility criteria:
inclusion criteria: 1. patients who will be undergoing a total hip replacement with a stryker trident ii cup 2. patients have signed an institutional review board (irb) approved consent form 3. patient is 21-80 4. patient has a diagnosis of non-inflammatory degenerative joint disease 5. patient is willing and able to comply with postoperative scheduled clinical evaluations. exclusion criteria: 1. patients who have not been consented as part of the collaborative orthopaedic replacement registry (corre) database 2. patients with other joint replacements (shoulder/knee) 3. patients with bilateral hip replacements 4. prisoners 5. international patients

Keywords: metal ion levels, total hip replacement, trident ii cup.
single-operator wire-guided endoscopic retrograde cholangiopancreatography cannulation technique

Conditions: Biliary Diseases; Pancreas Diseases

Summary: the single-operator wire-guided cannulation technique doesn't require an experienced assistant and precise coordination between the assistant and endoscopist.

a new single-operator wire-guided cannulation technique was performed on all patients. all procedures were performed by the same experienced endoscopist, but with different assistants in two groups (with an experienced one in group a, and a new trained one in group b). the number of attempts at cannulation, cannulation time, success rate, and procedure-related complications were compared between the two groups.

Eligibility criteria:
inclusion criteria: * hospitalized patients with pancreas and biliary diseases referred to the authors for ercp exclusion criteria: * previous endoscopic sphincterotomy, * surgically altered anatomy (e.g. billroth ii gastrectomy) or * diagnostic duodenoscopy

Keywords: endoscopic retrograde cholangiopancreatography (ercp) guidewires cannulation single-operator c-hook