Kornimate/medical-research-clean huggingface dataset:
skin refrigerant to reduce the pain associated with iv insertion

Conditions: Pain

Summary: the purpose of this study is to determine whether or not the pain of iv catheter insertion in the emergency department can be reduced significantly with the use of a rapid acting topical anesthetic spray and to determine whether or not healthcare providers who undergo such treatment are likely to endorse its use in their future practice.

we recruited 38 emergency department healthcare providers (doctors, physician assistants, nurses and medics) to receive a total of two separate iv canulations - one in one arm and the other in the other. one iv canulation would be pretreated with ethyl chloride topical anesthetic (the study product) and the other would be pre-treated with a placebo (sterile water in an aerosol can). both the participants and the nurses, pas and medics who placed the ivs were blinded as to which was the ethyl chloride and which was the placebo. after the ivs were placed the participants were asked to rate the pain of iv canulation on a scale of 1 to 10 for each of the pre-treatments, to state which one they believed to be superior in reducing the pain of receiving the iv, to state whether or not they would like the intervention that they rated as superior to be used on themselves and finally how likely they were on a 5 point scale to incorporate the intervention they rated as superior into their future practice.

Eligibility criteria:
inclusion criteria: 1. at least 18 years of age 2. a healthcare worker who routinely orders or places iv catheters. 3. consents to participate in the study. exclusion criteria: 1. history of hypersensitivity to ethyl chloride. 2. break, or swollen in the skin at the proposed iv site. 3. pregnancy or lactating female. 4. recent tattoo in either of the two proposed anatomical areas for iv cannulation. 5. skin infection in either of the two proposed anatomical areas for iv cannulation. 6. missing a contralateral limb to place the second iv. 7. recent trauma to one of the upper extremities or any neuropathic or radicular condition that could affect the participant's perception of pain in the antecubital fossa of each arm. -

Keywords: topical anesthetic ethyl chloride pain reduction iv cannulation
s-adenosylmethionine (same) in patients with primary sclerosing cholangitis (psc)

Conditions: Primary Sclerosing Cholangitis (PSC)

Summary: the aim of this study is to investigate clinical effects (liver biochemistries, health-related quality of life, liver stiffness) and underlying mechanisms of hepatoprotection of s-adenosylmethionine in patients with primary sclerosing cholangitis. the study will be performed in a randomized and placebo-controlled fashion.

the study is designed as a randomised, double-blind, placebo-controlled trial. eighty participants will be randomized in 1:1 ratio to one of two arms of the study: intervention or placebo. participants in intervention group will be treated with s-adenosyl-l-methionine 1200 mg/daily in tablets in two divided doses (800mg in the morning and 400mg midday) over the period of 6 months. patients in placebo group will receive a placebo of identical appearance, smell and taste, with the same schedule. participants will be monitored in out-patient clinic at baseline, interim visits at weeks: 4, 12, end of treatment at 24 weeks and follow-up visit after 4-6 weeks wash-out period. treatment adherence, adverse events, serum biochemistry and health related quality of life will be assessed at each visit. liver fibrosis will be measured with transient elastography at baseline and at the end of treatment.

Eligibility criteria:
inclusion criteria: * primary sclerosing cholangitis fulfilling easl criteria; * age: 18 - 75 years; * treatment with ursodeoxycholic acid (udca) in a dose of 13-15mg/kg b.w. for at least 6 months. exclusion criteria: * inability to give informed consent; * patients with other forms of chronic liver diseases; * decompensated liver cirrhosis (child-pugh class b-c); * patients with psc who underwent stenting of their biliary tree within 6 months; * other diseases or states that can affect quality of life and mood: decompensated diabetes mellitus, renal insufficiency requiring dialyses, malignancy, heart failure ≥ new york heart association (nyha) ii, organ transplantation, known hiv infection, rheumatoid arthritis, asthma, psychiatric disorders; * treatment with: steroids, statins, rifampicin, antidepressants; * pregnant or breastfeeding women; * history of hypersensitivity reactions to s-adenosylmethionine; * any other condition, which in the opinion of the investigators would impede the patient's participation or compliance in the study.

Keywords: psc
clinical results after judet quadricepsplasty for post-traumatic knee stiffness

Conditions: Knee Fractures; Stiffness of Knee, Not Elsewhere Classified

Summary: the post-traumatic extension contracture of the knee (peck) is a common complication following knee traumas. it is characterized by a restricted range of motion (rom), pain, and discomfort in the affected knee. various factors can cause peck, primarily inflammation and scar tissue formation. the underlying inflammatory state leads to the development of scar tissue, which - when combined with immobilization - results in the progressive stiffness of the knee. additionally, prolonged immobilization leads to muscle atrophy and, consequently, reduced mobility and increased rigidity. all these conditions contribute to a limited rom, making it challenging to perform various daily activities. sometimes conservative treatments can be effective, but surgery is often necessary to restore joint functionality and alleviate pain. historically, various surgical approaches have been proposed to address post-traumatic knee stiffness. open surgery is typically reserved for cases where arthroscopic adhesion release and manipulation under anesthesia have not been successful. over the last century, various open surgical techniques have been proposed. in particular, arthromyolysis according to judet was first described in the 1950s by the french orthopedic surgeon jacques judet. this technique involves a series of incisions and soft tissue releases, allowing the surgeon to resolve the stiffness of the quadriceps tendon caused by trauma or prolonged immobilization. although effective in restoring knee joint functionality, arthromyolysis according to judet is not without risks and potential complications. these include infection, massive bleeding, nerve and muscle-tendon injuries, and residual stiffness. the purpose of this study is to analyze our case series related to arthromyolysis according to judet for peck. clinical outcomes, complications, and patient satisfaction following this type of intervention will be evaluated.


Eligibility criteria:
inclusion criteria: 1. adult patients underwent surgical intervention for arthromyolysis according to judet with modified surgical technique for knee stiffness from january 2008 to december 2019. 2. patients with post-traumatic injuries (fractures treated surgically). 3. patients with a minimum of 4 years of follow-up. 4. completeness of clinical documentation. exclusion criteria: 1. patients who underwent surgical intervention for arthrolysis (both arthroscopic and non-arthroscopic) or arthromyolysis according to judet with minimally invasive technique. 2. patients who underwent surgery to address knee stiffness due to other causes (rigid prosthesis, limb lengthening, etc.). 3. incomplete clinical documentation.

Keywords: arthromyolisis judet post-traumatic quadricepsplasty
use of post operative loperamide in colorectal patients after diverting ileostomies

Conditions: Dehydration, Diverting Ileostomy, Loperamide

Summary: dehydration post creation of a diverting ileostomy is a common and debilitating problem faced by patients undergoing ileal-anal pouch anastomoses for both inflammatory bowel disease and familial adenomatous polyposis (fap) syndrome. those patients with low rectal cancers or other polyposis syndromes e.g. hnpcc hereditary non polyposis colorectal cancers, may potentially have a delay in the adjuvant therapy when faced with this complication. studies performed in this groups of patients report a readmission rate of 17-21% for dehydration. loperamide has been shown to significantly decrease the daily volume of weight of stool in these patients. the purpose of this study is to establish whether loperamide given at 4mg three times daily for 14 days from day of discharge empirically decreases 30 days readmission rate for dehydration. the investigators hypothesize that there will be a 15% decrease from 25% to 10% in the readmission rates, that severity of dehydration will be decreased.


Eligibility criteria:
inclusion criteria: 1. able to freely give written informed consent to participate in the study and have signed the informed consent form; 2. males or females, age 18 and older at the time of study screening; 3. american society of anesthesiologists (asa) class i-iii (appendix iii) undergoing elective surgery exclusion criteria: 1. mentally incompetent or unable or unwilling to provide informed consent or comply with study procedures 2. american society of anesthesiologists (asa) class iv or v; emergency surgeries 3. children \<18 4. pregnant patients 5. patients who have intra-abdominal sepsis or partial or intermittent bowel obstruction or enteritis 6. patients who are on long term steroids, opioids or antidiarrheals pre operatively 7. patients who are administered pro kinetics eg. metoclopramide 8. patients with recurrent disease in their small bowel - crohn's disease, or previous irradiated pelvis resulting in irradiation bowel disease 9. end ileostomies
effectiveness of golimumab in patients with ulcerative colitis: results of a real-life study in switzerland

Conditions: Ulcerative Colitis; Flare Up, Symptom

Summary: tnf inhibitors have improved treatment options for patients with inflammatory bowel disease (ibd) and three tnf inhibitors, infliximab, adalimumab and golimumab are available for treatment of ulcerative colitis in switzerland. however, these drugs have been tested under ideal conditions in randomized controlled trials. real-world data are needed to complement this information. it is the aim of the investigators to study, whether patients with ulcerative colitis can be effectively treated with golimumab in a real world setting in switzerland. the investigators used data from the swiss ibd cohort study (sibdc) in switzerland and identified all sibdc patients with uc treated with golimumab and performed a retrospective chart review. the investigators acquired patient reported outcomes and objective measures for inflammation at baseline, at 6-10 weeks and at 6 and 12 months after golimumab treatment. primary endpoint was clinical response (i.e. meaningful improvement) at 6-10 weeks. secondary endpoints were clinical response at 6 and 12 months and clinical remission (i.e. free of symptoms of disease).

ulcerative colitis patients from the swiss ibd cohort study treated with golimumab were identified. the investigators performed a retrospective chart review and assessed patient reported outcomes and objective measures of inflammation to assess response and remission. as clinical response in uc the investigators defined a composite end point of: marked improvement in partial mayo score and improvement in one or more of the following parameters (acquired during chart review): * endoscopy data * ultrasonography * calprotectin (cut off 100microg/g) * crp * anemia resolution marked improvement was defined as: clinical response based on partial mayo score (including physician global assessment): decrease in partial mayo score ≥ 2 points and ≥ 30% from baseline and a decrease in rectal bleeding subscore ≥ 1 point or absolute rectal bleeding score ≤ 1. improvement in lab work was defined as a reduction of the difference between baseline values and the next limit of normal by ≥ 30%. improvement in endoscopy/ ultrasonography was defined as a reduction of colitis in the same technique compared to baseline substantiated by images (endoscopy) or measurements of diameter of the bowel wall. as clinical remission in uc we defined normalization (i.e. absence of pathology) of patient reported outcomes (frequency of stool, blood in stool) and no evidence of residual disease activity in all of the following parameters: * endoscopy data * ultrasonography * calprotectin (cut off 100microg/g) * crp and anemia

Eligibility criteria:
inclusion criteria: * patient of the swiss ibd cohort study * diagnosis of ulcerative colitis * past treatment with golimumab (at least one dose) exclusion criteria: * none

Keywords: golimumab ulcerative colitis tnf-inhibitors clinical response clinical remission
galvus on met phase 4 study : study to evaluate the efficacy and safety of early combination of vildagliptin and metformin in patients with type 2 diabetes mellitus

Conditions: Type 2 Diabetes Mellitus

Summary: the study design of this trial is open-label, randomized, multi-center, parallel-group study.

* the progressive nature of t2dm will require the use of combination therapy in many patients over time to achieve and maintain glycemic control. early combination, compared with maximal dose of monotherapy, could be more effective in lowering glycemia with better tolerability. * vildagliptin is a new oral antidiabetic drug acting as a potent and selective inhibitor of dipeptidyl peptidase-4(dpp-4), the enzyme responsible for the rapid degradation of circulating glucagon-like peptide-1. vildagliptin improves islet function by a mechanism of increasing plasma levels of the active forms of the incretin hormones, glp-1 and gip. * metformin improves hyperglycemia primarily through its suppression of hepatic gluconeogenesis as well as enhancement of peripheral glucose update. metformin is the most commonly prescribed first-line antidiabetic drug worldwide, but due to the progressive worsening of blood glucose control during the natural history of type 2 diabetes, combination therapy usually becomes necessary. * thus their combination therapy with complimentary action mechanism could be as effective as up titration of monotherapy.

Eligibility criteria:
inclusion criteria: * patients with type 2 diabetes mellitus who were inadequately controlled (baseline a1c of 7.0\~11.0%)on metformin monotherapy (1500mg metformin)for ≥ 2 months before baseline visit * age of 18-80 years * body mass index of 18-40 kg/m2 exclusion criteria: * type 1 of diabetes * myocardial infarction, unstable angina, or coronary artery bypass graft within the previous 6 months * congestive heart failure (iii or nyha class iv) * liver disease such as cirrhosis or chronic active hepatitis * history of lacticacidemia * use of any oral anti-diabetic drug other than metformin within the 2 months * use of insulin before screening visit * alt or ast \>3 times the upper limit of normal range * creatinine \>1.5 mg/dl * other situation (pregnant or lactating females, history of drug or alcohol abuse, night-shift workers, clinically significant laboratory abnormality on screening or any medical condition that would affect the completion or outcome of the study)

Keywords: galvus
adaptation and validation of frailty scales in intensive care units in spain

Conditions: Frailty Syndrome

Summary: increased life expectancy leads to population aging, increased morbidities and aging of hospitalized patients. the acquisition of frailty leads to worse outcomes derived from hospitalization, but although frailty has been related to aging, young patients admitted to intensive care units (icu) with frailty have also been found to have worse outcomes than non-frail patients. this unfavorable evolution could be related to the acquisition of the post-uci syndrome (physical, mental and cognitive sequelae at discharge from the icu), since high frailty scores favor this syndrome. the use of frailty scales on admission to the icu could provide early detection of patients most likely to develop post-icu syndrome, regardless of age, and redirect our care to those who need it most. some scales that measure frailty in elderly patients have been used in the icu, but although they have been validated in their original language, they need to be adapted and validated in spanish. objectives. adaptation and validation of the clinical frailty scale (cfs) and the frail scale in icu patients of different ages, in women and in men. methodology. study developed in two phases.phase 1, adaptation to spanish of the scales (translation, pilot, back-translation, correlation); phase 2, analysis of their metric properties (validity, reliability, sensitivity, minimum important difference) by means of a multicenter observational study (7 icus in spain), prospective, descriptive, of a cohort of critical patients with one-year follow-up (at 3, 6, 9 and 12 months after hospital discharge).


Eligibility criteria:
inclusion criteria: - critical care patients over 18 years who have given their consent personally. exclusion criteria: * patients admitted with a diagnosis of present or imminent brain death, * readmissions previously included, * patients whose expected stay is less than 48 hours * patients with comunication problems

Keywords: frailty critical care gender reliability validity study transcultural quality of life
physical activity in minority women with asthma intervention

Conditions: Asthma

Summary: the action intervention: physical activity in minority women with asthma is a 3lifestyle physical activity intervention refined to be applicable for sedentary african american (aa) women with asthma. the main outcome of this study is to test the feasibility, acceptability and estimate the efficacy of the action intervention in a randomized controlled pilot of 80 aa women with asthma within a pragmatic community setting at 24-weeks.

asthma is a highly prevalent chronic disease that disproportionately impacts african american (aa) women. aa women have poorer asthma-related quality of life and higher rates of asthma exacerbations, healthcare utilization and mortality compared to caucasian women. further, aa women are less physically active than any other subgroup of adults, which may help explain the asthma health disparities, found between aa and caucasian women. physical inactivity among individuals with asthma is associated with poor asthma control and respiratory function, greater health care utilization, and poorer quality of life. given the connection between poor asthma outcomes and physical inactivity, addressing physical activity (pa) among sedentary aa women with asthma is imperative. physical activity demonstrated improvement in asthma outcomes specifically asthma control, quality of life and healthcare utilization. despite these benefits, fewer than 25% of aa women with asthma engage in regular physical activity. the action intervention: physical activity in minority women with asthma is a lifestyle pa intervention refined to be applicable for sedentary aa women with asthma.

Eligibility criteria:
inclusion criteria: * self-identify as female and black or aa * age 18-70 * sub-optimally controlled persistent asthma based on asthma control test (act \<20) * wiling to enroll and provide written-informed consent * willing to be randomly assigned to treatment or control group exclusion criteria: • plans to relocate outside of the chicagoland area during the study period. * unable to ambulate without human assistance (ie. use of a wheelchair, scooter) * history of significant mental illness (e.g. uncontrolled bipolar disorder, psychoses) * currently pregnant, planning to become pregnant over the next 3 months * diagnosis of copd (emphysema or chronic bronchitis) suggested by patient report of doctor diagnosis or smoking history (\>20 pack years) * poorly controlled high blood pressure (bp \>180/100 at baseline visit) * family/household member of another study participant or staff member * inability to speak, read or understand english; * investigator discretion for safety or protocol adherence reasons * participation in action focus groups (aim 1) or pre-pilot (aim 2) of the study

Keywords: walking african american women lifestyle
cerebral vascular effects of dexmedetomidine versus propofol sedation in intubated mechanically ventilated icu patients

Conditions: Sedation

Summary: serial transcranial doppler (tcd) exams in healthy volunteers and in animal models showed a strong linear relationship between middle cerebral artery (mca) flow velocity (fv) and dexmedetomidine infusion. the concomitant elevation of pulsatility index (pi) indicates vasoconstriction of the cerebral vasculature as the most profound underlying mechanism.

available clinical evidence on the use of dexmedetomidine sedation in neurosurgical and neurocritical care is limited and no definite conclusion can be drawn. there is a need for the use of dexmedetomidine might be a useful adjunct in clinical situations when the increase in cbf could be detrimental such as vasogenic cerebral edema (i.e., tbi, large brain tumors). however, dexmedetomidine sedation is questionable in patients with subarachnoid hemorrhage and acute stroke, since the associate drop in arterial pressure could worsen the coexisting increase in circulating catecholamines and massive sympathetic outflow. further high-quality rcts to evaluate the use of dexmedetomidine as a sedative agent both in general icu patients and in patients with tbi. transcranial doppler (tcd) is a simple noninvasive bedside tool to assess the cerebral blood flow pattern. the new development of transcranial color doppler with angle correction option helps to improve the sensitivity of test results. tcd can assess the evolution of cbf alterations and possibly cerebral autoregulation performance and icp estimation in patients presenting with cerebral pathology.

Eligibility criteria:
inclusion criteria: * adult trauma patients (18-50 years old, asa i-ii). * with and without mild tbi. * mild traumatic brain injury will include; brain edema, brain contusion, fracture base, fissure fracture and depressed fracture. * the severity of traumatic brain injury will be defined as mild based on basal glasgow coma scale and basal computerized tomography scanning. * requirements of endotracheal intubation, mechanical ventilation and light to moderate sedation because of associated abdominal or chest traumatic injuries. * the sedation needed should of an estimated duration not less than 24h. * baseline hemodynamic parameters within the normal range. * baseline middle cerebral artery flow velocity within the normal range. exclusion criteria: * severe traumatic brain injury, subarachnoid hemorrhage and intra-cerebral hemorrhage. * spinal cord injury. * hemodynamically unstable patients and patients on inotropes. * patients who have a cardiac pacemaker or automatic implantable cardioverter defibrillator. * patients with hepatic or renal impairment. * pregnant females. * patients who are incarcerated.