Kornimate/medical-research-clean huggingface dataset:
effect of sevoflurane, propofol and dexmedetomidine on delirium & neuroinflammation in mechanically ventilated patients

Conditions: Delirium

Summary: assessment of sedative effects of sevoflurane, dexmedetomidine and propofol on the clinical course of delirium, sirs and neuroinflammation in mechanically ventilated patients using cam-icu scale, gsk-3beta and protein s100b in serum.


Eligibility criteria:
inclusion criteria: * presence of delirium exclusion criteria: * presence of alzheimer's disease * any mental disorder * presence of cancer
repetitive transcranial magnetic stimulation in cancer pain management

Conditions: Pain; Cancer

Summary: over half of cancer patients experience cancer-related pain. despite advances in pain management with opioids, many patients continue to suffer from chronic cancer pain. the underlying mechanisms of cancer-related pain remain poorly understood, but they may be linked to brain neuroplasticity. as a result, some researchers suggest that targeting the motor cortex in cancer patients could improve pain management. however, few studies have investigated the effectiveness of remodeling neuroplasticity with repetitive transcranial magnetic stimulation (rtms) to reduce cancer-related pain. to validate the use of rtms in cancer-related pain, we plan to conduct a randomized controlled trial involving 30 cancer pain patients. participants will be randomly assigned to receive either rtms or sham rtms treatment. functional magnetic resonance imaging (fmri) and pain index assessments will be conducted before and after the treatment to evaluate the outcomes.


Eligibility criteria:
inclusion criteria: 1. patients have cancer pain symptoms, confirmed by a physician as cancer pain or neuropathic cancer pain 2. experienced the worst pain nrs score ≥ 4 3. the patient demonstrate good cognition and is able to cooperate with the assessment of pain severity. 4. the estimated survival time exceeds 3 months. 5. pre-existing bisphosphonate, chemotherapy, and hormonal therapy regimens remained unchanged throughout the study. exclusion criteria: 1. individuals who have undergone head surgery or have metal implants in the head. 2. individuals with implanted cardiac pacemakers or cochlear prostheses. 3. have a history of epilepsy. 4. patients diagnosed with primary brain tumors or metastatic brain lesions. 5. present with additional neurological, psychiatric, or severe medical disorders. 6. individuals with metallic implants located in the cranial or cervical regions. 7. women who are pregnant. 8. presence of acute pain in any body region attributable to other medical conditions. -
oxygen targets in acute heart failure with pulmonary congestion

Conditions: Acute Heart Failure; Pulmonary Congestion; Hypoxemia

Summary: this investigator-initiated, prospective, randomized, blinded, multi-center, controlled trial will investigate the effect of a restrictive vs. liberal oxygenation-strategy in patients hospitalized with acute heart failure with pulmonary congestion. patients will be randomized 1:1 in the emergency department to either liberal or restrictive oxygenation after providing informed written consent. 1. liberal oxygenation group = spo2 target of 96%. 2. restrictive oxygenation group = spo2 target of 90%. the allocation will be concealed through the use of an oxygen-delivery robot, termed o2matic. the study will include 122 patients.

background: one million hospitalizations occur each year with a primary diagnosis of acute heart failure in the usa, with comparable numbers in europe. most patients with acute heart failure are treated with supplemental oxygen during hospitalization and guidelines recommend initiation of oxygen therapy if spo2 \<90% (class i, level c). however, no clinical trials of oxygen targets in humans with acute heart failure investigating clinically relevant endpoints have been performed. primary objective: to investigate the effect of a restrictive vs. liberal oxygenation-strategy in patients hospitalized with acute heart failure. hypothesis: restrictive oxygenation is associated with improved clinical outcome compared to liberal oxygenation. design: investigator-initiated, prospective, randomized, blinded, multi-center, controlled trial. intervention: patients will be randomized 1:1 in the emergency department to either liberal or restrictive oxygenation after providing informed written consent. 1. liberal oxygenation group = spo2 target of 96%. 2. restrictive oxygenation group = spo2 target of 90%. patients will have nasal cannula or oxygen mask placed as the usual care, and oxygen is titrated to the prespecified target range. consented patients will be randomly allocated to study groups via the automated web-based system within redcap. the allocation will be concealed. time at randomization will be considered as study time zero (t0). all patients will receive usual standard of care except for their oxygen-administration. the intervention-phase will be 24 h, and hereafter oxygen therapy will be at the discretion of the treating physician.

Eligibility criteria:
inclusion criteria: 1. age ≥ 18 years 2. acute (within minutes to days) onset or worsening of subjective dyspnea 3. oxygen saturation \<92% (on arterial blood gas) or need of oxygen 4. at least one of the following clinical or radiological signs of congestion: 1. pulmonary rales 2. chest x-ray or ct with pulmonary congestion 3. lung ultrasound with multiple b-lines exclusion criteria: 1. more than 4 hours from hospital admission to randomization 2. suspected infection or sepsis 3. known severe pulmonary disease 4. systolic blood pressure \<90 mmhg

Keywords: acute heart failure pulmonary edema oxygen pulmonary congestion
safety, tolerability and pk/pd study in young adult patients with childhood onset growth hormone deficiency (ghd).

Conditions: Growth Hormone Deficiency

Summary: study to find the optimal dose of growth hormone replacement in young adult patients suffering from childhood onset growth hormone deficiency (ghd).

the primary objective of this study is to evaluate the safety, tolerability and pharmacodynamic response of three different arx201 doses (peg-ahgh) when administered repeatedly to young adult patients with childhood onset growth hormone deficiency (ghd).

Eligibility criteria:
inclusion criteria: * 18-30 years old * ghd of childhood onset * completed growth * igf-1 \<=2sds * rhgh treatment naive * hgh levels below cut-off exclusion criteria: * history of malignancy or intracranial tumors * ecg abnormality * ich * hepatic dysfunction * renal impairment * major medical conditions * inadequate t4 * positive for hbv, hcv, or hiv * alcohol or drug abuse

Keywords: growth hormone growth hormone deficiency ghd peg pegylated igf-1
fluid oriented therapy during major abdominal surgery

Conditions: Goal Directed Therapy

Summary: in this "before and after" study we will investigate the potential benefit on postoperative outcomes of a guided fluid therapy with a stroke volume optimization . the nice protocol has been applied by means of ev1000 monitor and arterial waveform analysis ( flotrac - edwards). in the postoperative period overall complications, as well as exitus , will be analyzed and compared with those of a control group underwent the same surgical interventions, with a standard hemodynamic monitoring.


Eligibility criteria:
inclusion criteria: * asa 1-2 patients exclusion criteria: * severe caridiac disease * renal failure

Keywords: [g09.330.380]
pressure sore-related osteitis treated by flap coverage and short antibiotic regimen

Conditions: Pressure-related Osteitis

Summary: pressure ulcers associated with osteitis are frequent among patients with spinal cord injury (sci), and optimal management is not well known. in a french referral center, debridement and flap coverage surgeries performed simultaneously are followed by a short antibiotic treatment targeting the bacteria involved. the aim of the study is to evaluate patient's outcome at day 45 after surgery, and identify factors associated with failure.

spinal cord injured (sci) population is subject to pressure ulcers because of numerous risk factors: neurological disorders, which reduce ability to mobilization, potential, undernutrition, confinement to bed, and vascular disorders promoting the lesions. despite the attention given to preventative strategies, in this population, prevalence of pressure ulcers varies from 10% to 30%, with an annual incidence rates range ranging from 20%-% to 31%. in community-dwelling sci population, stages iii and iv pressure ulcers account for 25% of total ulcers observed. they are a major cause of healthcare centers admissions or homecare nursing. duration of ulcers could vary from 1 week to 3 years. also, their occurrence is associated with potential repeated hospitalizations and with a longer length of stay. furthermore, pressure ulcers are an important economic burden to the health care system. pressure ulcers interfere with the patient's physical, psychological, and social well-being and impact the overall quality of life. over recent years, an increased pressure ulcer prevalence has been reported. therefore, they are frequent and their clinical spectrum is wide. they also readily become superinfected and can lead to sepsis. establishing the diagnosis of osteomyelitis in this setting is challenging, and physicians often struggle with the appropriate therapeutic management. a recent review did not find evidence of benefit of antibacterial therapy in osteomyelitis associated with pressure ulcers without concomitant surgical debridement and wound coverage. but this type of management remains controversial. in a french referral center, patients with pressure ulcer-related osteitis benefit from a one-stage surgical management with bone shaving and flap covering, followed by a probabilistic post-operative antibiotic treatment, secondarily adapted to peroperative samples, for a total duration of effective antibiotic treatment of 7 or 10 days. thus, the investigators aim to evaluate this original strategy, identify risk factors for failure, and focus on the role of antibiotic treatment.

Eligibility criteria:
inclusion criteria: * patient ≥ 18 years; * spinal cord injured patients with pressure-related osteitis treated with flap coverage and short antibiotic treatment. exclusion criteria: * patient \< 18 years; * patient under under guardianship; * patient with concomitant infections; * patient having declare his opposition to study participation.

Keywords: osteitis flap surgery short-course antibiotics
transplantation of autologous oral mucosal epithelial sheets for limbal stem-cell deficiency

Conditions: Limbal Stem-cell Deficiency

Summary: the study purpose is to evaluate the efficacy and safety of cultivated oral mucosal epithelial sheet transplantation as a novel therapy for limbal stem cell deficiency, for which no effective approaches has thus far been available, for the purpose of establishing this therapy as an effective strategy for this disease with an aim of improving visual acuity and corneal transparency.

the efficacy and safety of cultivated oral mucosal epithelial sheet transplantation as a novel therapy for limbal stem-cell deficiency, for which no effective approaches have thus far been available, will be evaluated for the purpose of establishing this therapy as an effective strategy for this disease with an aim of improving visual acuity and corneal transparency. the primary endpoint will be an area of no conjunctivalization and no corneal epithelial defect at one year, which will be evaluated according to a 6-grade rating scale. the secondary endpoints will be corrected visual acuity, severity of corneal opacification, extent of corneal neovascularization, expected ocular complications, and all adverse events including abnormal laboratory findings. the purpose of this research is to evaluate the efficacy of the investigational therapy so as to provide rationales for making this strategy approved as an advanced medical care in the future.

Eligibility criteria:
inclusion criteria: * among patients with bilateral limbal stem-cell deficiency, those who meet all the criteria listed below when they give their informed consent to participate in this research will be included. 1. patients in whom the eye(s) (subject to the interventional therapy) show(s) loss or dysfunction of corneal epithelial stem cells throughout the total\* circumference of the cornea 2. patients in whom the corneal surface of the eye(s) (subject to the investigational therapy) is(are) entirely enveloped by conjunctival tissue 3. patients of both genders aged ≥20 years when they give their informed consent 4. patients who have given their own written consent to participate in this clinical research (the target disease is bilateral limbal stem-cell deficiency, although it is not always necessary that the both eyes of the patient meet the inclusion criteria.) exclusion criteria: 1. patients who are or may be pregnant, and patients who are breast feeding 2. patients with infections (hbv, hcv, hiv, htlv-1) 3. patients with extreme hypolacrimation resistant to therapy 4. patients from whom oral mucosal specimens cannot be collected because clear scar formation or inflammatory findings are noted in a cell-collection site of the mucosal membrane 5. patients whose score of performance status (ps\*) is 3 or more 6. any others who are judged by the chief subinvestigator to be ineligible for this clinical research, due to the presence of complications, etc.
assessment of central pain in patients who undergo spinal surgery and influence in surgery outcome

Conditions: Spinal Surgery; Pain

Summary: * pain is one of the most common concerns for which patients seek medical attention. * pain is usually understood as symptom that reflects peripheral organic damage. many patients experience pain, often chronically, independently of any underlying cause such as chronic regional pain syndromes (irritable bowel syndrome, temporo-mandibular pain syndrome, chronic headache or chronic low back pain)or diffuse like in fibromyalgia. in all those "functional" syndromes, accumulated evidence supports involvement of central pain processing systems, hypothalamic pituitary adrenal axes and autonomic nervous system, and are now referred as central pain conditions. * other patients suffers from chronic pain caused by damage or inflammation in peripheral tissues, but also experienced more diffuse pain, not directly explained by peripheral damage, that further aggravates pain and function. this is illustrated by the high prevalence of fibromyalgia observed in patients with rheumatoid arthritis, osteoarthritis or ankylosing spondylitis for example. these pain conditions are now understood as combinations of peripheral, neuropathic and central pain. the investigators aimed to focus in this study in patients that are candidates to spinal surgery and suffer from low back pain and/or radiculopathy. pain in these patients may arise from damage to nerves - neuropathic pain- , to musculoskeletal structures - peripheral pain-, and may also reflects alteration in central pain processes. in these patients, spine surgery is usually performed to improve quality of life, decrease pain and avoid neurological deficits. evaluation of surgical outcome includes objective measures such as neurological findings and radiographic evaluation, and subjective measures including patient self-assessments for pain and quality of life and psychological changes. the aim of this study is to evaluate patients who undergo spinal surgery for presence of central pain and central sensitization symptoms and evaluate their influence on these surgical outcomes


Eligibility criteria:
inclusion criteria: * candidates to spinal surgery attending the spine clinic * able to give inform consent exclusion criteria: * pregnant women * children under 18 * current infection in spine

Keywords: central pain spine surgey outcome patients undergo spinal surgery
intraoperative hypotension in high-risk patients undergoing surgery

Conditions: Anesthesia; Hypotension on Induction; Perioperative Injury; Perioperative Hypotension

Summary: the primary objective of this observational study is to investigate the risk factors for intraoperative hypotension and identify the underlying pathomechanisms leading to it, both during the period after general anesthesia induction and throughout its course. the main questions it aims to answer are: * how frequent is intraoperative hypotension * what are the underlying pathomechanism causing it the study is including patients who have been identified as having a high risk of perioperative complications (asa3 or asa4). patients included in the study undergo advanced hemodynamic monitoring during the procedure. anesthesia induction, maintenance, and termination are conducted by an anesthesiologist in accordance with current medical knowledge, and the planned experiment does not in any way influence the course of action. investigators will analyse medical documentation, including the patient's medical history, anesthesia records, and hemodynamic parameter data obtained from the hemodynamic monitor (an excel file containing comprehensive data related to specific cardiovascular parameters) to describe the incidence of intraoperative hypotension and answer key questions in accordance with the designed study protocol.


Eligibility criteria:
inclusion criteria: * age \>18 years old. * capability of providing informed consent by the patient. * planned surgeries. * surgeries other than thoracic, cardiac, or obstetric procedures. * asa (american society of anesthesiologists) physical status classification of 3 or 4, indicating high risk. * patients at high risk of postoperative complications. * preoperative qualification for advanced hemodynamic monitoring. * access to complete preoperative health status data. * access to complete data regarding the course of anesthesia and hemodynamic parameters obtained from the hemodynamic monitoring platform. * initiation of hemodynamic monitoring prior to general anesthesia induction. exclusion criteria: * age \<18 years old. * cardiac surgeries. * thoracic surgeries. * obstetric procedures. * inability of the patient to provide informed consent. * asa physical status classification of 1, 2, or 5, indicating low or moderate risk. * urgent and emergent surgeries. * lack of complete preoperative health status data. * lack of complete data regarding the course of anesthesia. * inability to initiate hemodynamic monitoring prior to general anesthesia induction. * interruption in hemodynamic monitoring lasting longer than 5 minutes (lack of parameter values in the obtained hemodynamic monitor file).
validation of a method of screening for sleep disorders in children with cerebral palsy, using connected tools

Conditions: Sleep Disorders

Summary: cerebral palsy (cp) is the most common cause of child disability. nearly 40% of pc children suffer from sleep disorders, which are not routinely screened. the neuro-cognitive, physical and environmental morbidity of sleep disorders should require their diagnosis and management. limited access to the reference exam (polysomnography or psg) delays the diagnosis and only allows screening of these disorders for a limited number of pc children. the hypothesis of our study is that connected technologies could optimize screening for sleep disorders in pc children by selecting children requiring psg exploration and specific management.


Eligibility criteria:
inclusion criteria: * boy or girl between 6 and 15 years old * confirmed diagnosis of cerebral palsy * gmfcs class\> 3 * parents and child agreement exclusion criteria: * pharmacological treatment of sleep disorders * diurnal and / or nocturnal ventilatory support * difficulty understanding and / or participation * subjects under 6 and over 15 * refusal to participate * not affiliated with and not a beneficiary of a health insurance plan

Keywords: screening sleep disorders children cerebral palsy connected tools
assessing the effect of contact isolation on nosocomial colonization with esbl-ec in german hematology/oncology wards

Conditions: Oncology [See Also, Affected System]; Hematological Disease; Infection Due to ESBL Escherichia Coli

Summary: this study aims to evaluate the impact of contact isolation on the rate of hospital-acquired transmissions of esbl-producing escherichia coli (esbl-ec) and the rate of colonization and infection. on the basis of this study, it will be possible to re-evaluate the need for contact isolation for patients colonized or infected with esbl-ec.

the study aims to evaluate the impact of contact isolation on the rate of hospital-acquired transmissions of esbl-producing escherichia coli and the rate of colonization and infection. hematological and oncological wards in hospitals with a non-outbreak setting for esbl-ec and adhering to at least the following standard of care are eligible for study participation: * fecal screening for the presence of esbl-ec of all patients within 72 hours of each admission by use of a rectal swab or stool sample * follow-up fecal screening once a week and within 72 hours of discharge * implementation of clinical standards aimed at esbl-ec decolonization is not allowed on wards participating in this study, including in the context of clinical studies. sites will be grouped according to their approach regarding contact isolation (see group description). as a control for external factors a hand hygiene program, including training and adherence assessments, will be implemented.

Eligibility criteria:
inclusion criteria: * wards adhering to at least the following standard of care are eligible for study participation: * fecal screening for the presence of esbl-ec of all patients within 72 hours of each admission by use of a rectal swab or stool sample * follow-up fecal screening once a week and within 72 hours of discharge exclusion criteria: * none

Keywords: colonization multi-resistant gram negative bacteria infection control measures hand hygiene program contact precautions immunocompromised host
parenting skills for mothers with borderline personality disorder: a newly developed group training program

Conditions: Borderline Personality Disorder

Summary: n=15 mothers with borderline personality disorder who had young children (aged 0-6 years) participated in a 12-week training program. to estimate the participants' impairment, parental stress and psychological distress were assessed before the training. after the training, participants and trainers were asked to provide feedback regarding the valuation of and the changes due to the training.


Eligibility criteria:
inclusion criteria: * borderline diagnosis in mothers * infants between 6 months and 6 years * mothers and their children must be in regular contact with each other exclusion criteria: * acute child endangerment * maternal acute suicidality
colistin-rifampin combination and colistin monotherapy in extensively drug-resistant acinetobacter baumannii

Conditions: Colistin; Rifampin; Acinetobacter Infections

Summary: the investigators aimed to confirm the utility of the synergy test results (e-test) in vitro to predict the efficacy and safety of colistin-rifampin combination and colistin monotherapy in extensively drug-resistant acinetobacter baumannii.

we will searched pneumonia patients with corab in gangnam severance hospital. subjects will be enrolled and randomized in a blinded fashion using a computerized random number generator (permuted-block randomization) for treatment with colistin and rifampin combination and colistin only at a ratio of 1:1. we will perform the e-test mic:mic ratio method to predict in vitro synergy of colistin and rifampin combination therapy.

Eligibility criteria:
inclusion criteria: * pneumonia, blood septicemia, urinary tract infection, or other infection or even colonization with evidence of extensively drug-resistant acinetobacter baumannii infection exclusion criteria: * hypersensitivity reaction to colistin or rifampin * use of colistin or rifampin in 15 days prior to screening * evidence of extensively drug-resistant acinetobacter baumannii infection in 15 days prior to screening * clcr \ 3xuln, total bilirubin \> 2xuln, hb \< 7 gm/dl, anc \< 500/mm3, platelet \< 50,000/mm3