Kornimate/medical-research-clean huggingface dataset:
home care management of pediatric pain

Conditions: Tonsillectomy

Summary: the purpose of this study is to determine whether around-the-clock dosing of pain medication, with or without nurse coaching, increases the effectiveness of pain management (i.e., decreased pain intensity scores with and without swallowing, increased use of pain medication, improved sleep, increased oral intake of fluids, decreased negative behaviors, and the same degree of side effects), over time, compared to standard care with "as needed" dosing.

the undertreatment of postoperative pain in children remains a critical problem. only recently have clinical trials begun to evaluate the efficacy of pharmacologic interventions in the management of postoperative pain beyond the immediate postoperative recovery period and after discharge home following tonsillectomy. given the fact that approximately 50% of pediatric surgeries are done on an outpatient basis, this study has the potential to improve the home pain management of thousands of children. this study is one of the first to evaluate in a systematic fashion the use of an around-the-clock dosing of a weight appropriate dose of a nonopioid/opioid combination analgesic compared to as needed dosing. because the study will evaluate the effectiveness of both a behavioral intervention and two different pharmacologic interventions, it will provide important information that should have a direct clinical application in the management of children's pain. the consent form is written according to the standards outlined by the committee on human research, including: 1) an explanation of the purposes of the research and the expected duration of the subject's participation; 2) a description of the procedures to be followed; 3) a description of any foreseeable risks or benefits to the subject, and any alternative courses of treatment; 4) a statement describing the extent to which confidentiality of records will be maintained; 5) a statement whether compensation will be provided and medical treatment made available if injury occurs; 6) the name and number of the chair of the committee on human research; 7) a statement that participation is voluntary, and that the subject may discontinue participation at any time; and 8) a statement indicating that the subject has received a copy of the consent document and related materials. a separate form is signed to authorize access to their health care information.

Eligibility criteria:
inclusion criteria: * outpatient tonsillectomy, with or without other minor procedures (e.g., ear tube placement); parental consent; child assent (age-appropriate); ability of the child to speak english; ability of the parents to read, write, and speak english; and, access to a telephone. exclusion criteria: * history of severe obstructive sleep apnea (causing the child to stop breathing repeatedly during sleep); known problems with vision, hearing, control and coordination of movement, or thinking ability.

Keywords: tonsils tonsillectomy
access: a controlled comparison of eritoran tetrasodium and placebo in patients with severe sepsis

Conditions: Severe Sepsis

Summary: the purpose of this study is to compare eritoran tetrasodium and placebo in patients with severe sepsis and to demonstrate a reduction of mortality from all causes.


Eligibility criteria:
inclusion criteria: * age \>= 18 years * confirmed early-onset severe sepsis, defined as: o---objective evidence of infection likely to be caused by a bacterial or fungal pathogen o---presence of at least 3 of 4 systemic inflammatory response syndrome (sirs) criteria o---sepsis-associated organ dysfunction * baseline acute physiology and chronic health evaluation ii (apache ii) score of 21 to 37 * \< 12 hours between onset of the first qualifying organ dysfunction and expected administration of study drug * a commitment to full patient support exclusion criteria: * pregnancy or breastfeeding * extensive (\>20% body surface area) third-degree burns * weight \> 150 kg at admission * patients whose death from sepsis is considered imminent * patients not expected to survive for at least 2 months due to a pre-existing and uncorrectable medical condition, or those in a chronic vegetative state * patients with severe congestive heart failure * patients currently receiving immunosuppressive therapy such as cyclosporine, azathioprine, or cancer chemotherapy * patients with granulocyte counts \< 1000/mm\^3 unless the decreased count is believed to be due to sepsis * patients that required cardiopulmonary resuscitation in the 4 weeks prior to evaluation for enrollment * human immunodeficiency virus (hiv)-positive patients with cd4 count \<= 50/mm\^3 within 4 weeks of enrollment, or end-stage processes * patients with significant hepatic impairment, portal hypertension, or esophageal varices * patients who are expected to be treated with endotoxin-removal devices * patients with active cancer * patients receiving polymyxin b or colistin

Keywords: severe sepsis septic shock sepsis
the adjunctive effect of a titanium brush in the non-surgical treatment of peri-implantitis

Conditions: Peri-implantitis; Titanium Brush; Non-surgical Submucosal Debridement

Summary: peri-implantitis is a plaque-associated condition occurring around dental implants, characterized by inflammation in the peri-implant mucosa and loss of supporting bone. to stop this progression, mechanical debridement of biofilm and calculus is commonly used to treat peri-implant lesions as well as the use of adjunctive measures such as titanium brushes. as observed, they improved plaque removal when compared with steel curettes alone. therefore, it is of interest to evaluate the impact of this procedure in terms of clinical, radiographic and microbiological outcomes to assess their efficacy.


Eligibility criteria:
inclusion criteria: * adult patients with ≥18 years of age. * ability to understand all the study procedures and to comply with them along the entire study period. ability and willingness to give written informed consent. * an adequate level of oral hygiene (plaque index ≤ 25%) (o'leary et al., 1972). * treated periodontal disease. * presence of at least one titanium implant with peri-implantitis \[i.e., presence of bleeding and/or suppuration on gentle probing with probing depth of ≥6 mm, and progressive bone loss. in the absence of initial radiographs, a bone level ≥2 mm apical to the most coronal part of the intrabony portion of the implant will be used as threshold of disease (romandini et al., 2021)\]. * horizontal and vertical peri-implant bone defects. * implant function time ≥ 1 year. * presence of ≥2mm of keratinized peri-implant mucosa. * screw-retained single and multiple restorations. exclusion criteria: * untreated periodontitis. * smokers \> 10 cigarettes per day. * local or systemic diseases that would interfere with routine periodontal therapy (i.e., uncontrolled diabetes mellitus, cancer, hiv, chronic high-dose steroid therapy, metabolic bone disease, radiation, immunosuppressive disease, hepatic dysfunction, immunosuppressive disease, autoimmune disease). * pregnant or lactating women. * previous surgical and non-surgical treatment of affected implants at least 12 months prior to the beginning of the study. * radiographic peri-implant bone loss \> two-thirds. * mobility of the implant. * known allergy or intolerance to macrolides. * use of systemic antibiotics during the last 3 months. * need of endocarditis prophylaxis.
effect of chest tube withdrawal on patients' anxiety levels after thoracic surgery

Conditions: Chest Tube Withdrawal; Video-assisted Thoracoscopic Surgery

Summary: since the removal of the chest tube is a painful procedure, it can cause serious anxiety in patients. patients state that chest tube removal is among the bad memories they experience. the source of the anxiety may be related to fear and anxiety about the pain caused by the upcoming chest tube removal procedure, or it may be the words they have heard from other patients who have had this experience before. there are a limited number of studies in the literature on anxiety that may occur in patients due to chest tube withdrawal. in addition, studies in the literature did not focus on whether there was a difference between pre-procedure and post-procedure anxiety levels. in this study, it was aimed to investigate the anxiety levels before and after the procedure and the pain levels felt in the patients due to the procedure due to chest tube withdrawal in patients who underwent vats. in addition, it aimed to investigate whether there is any correlation between pre-procedure anxiety and pain experienced during the procedure. if a correlation is detected, the importance of pre-procedural anxiety management will be better understood, the necessity of interventions such as psychological and pharmacological treatment for anxiety will come to the fore, and new research on this subject will be needed.


Eligibility criteria:
inclusion criteria: * the ages of 18-65 * bmi between 18-35 kg/m2 * who have undergone vats * who have a single chest tube inserted during surgery * who have undergone resection with vats (wedge resection, segmentectomy, lobectomy) exclusion criteria: * who have undergone surgery under emergency conditions, * who have undergone thoracotomy, decortication, pleural biopsy, * who constantly use anti-inflammatory or analgesic drugs, * patients with preoperative chronic pain, * who have undergone thoracic surgery before, * patients with a history of chest tube insertion and for any reason after surgery (prolonged air leakage), * patients whose chest tube has not been removed for more than 7 days, * who have undergone pleurodesis * patients with psychiatric diagnoses or who use psychiatric drugs * who are illiterate will be excluded from the study.

Keywords: chest tube withdrawal pain anxiety video-assisted thoracoscopic surgery vats
efficacy of n-acetylcysteine in improving/normalizing alt & ast in patients of nafld

Conditions: NAFLD

Summary: currently researches are focusing on the effect of antioxidants in the treatment of non-alcoholic fatty liver disease (nafld). since n-acetyl cysteine (nac) has been proven to have antioxidant and anti-inflammatory properties, therefore, we will conduct this study to determine the effect of nac in patients of nafld with raised liver enzymes.

the prevalence of non-alcoholic fatty liver disease (nafld) is increasing globally, and presents a challenge for the medical community since it has no fda approved treatment. an important feature of non-alcoholic fatty liver disease (nafld) is hepatic steatosis leading to hepatic dysfunction . it has been reported that nafld patients with increased liver enzymes have a greater risk of developing complications like cirrhosis and end-stage liver disease. since n-acetyl cysteine (nac) has been proven to have antioxidant and anti-inflammatory properties, therefore, we will conduct this study to determine the effect of nac in patients of nafld with raised liver enzymes (alt, ast). patients presenting with ultrasound showing fatty liver with raised liver enzymes will be recruited. they will be randomized into two groups (group a and group b). the odd number patients will be allocated group a and even number patients will be allocated to group b. group a: patients in this group will be advised to follow a diet plan \& daily 20 minutes brisk walking. group b: patients in this group will be given nac 200mg bd along with diet plan \& exercise. this drug will be provided to the patients by the investigators free of cost. the liver function tests and side effects of nac will be followed at 12 weeks .

Eligibility criteria:
inclusion criteria: * • patients of both genders between the ages of 20 years and 60 years, giving consent to be included in the study. * patients having fatty liver on ultrasound with raised alt and ast levels exclusion criteria: * • patients having other causes of steatosis eg, excessive alcohol consumption, * patients taking steatogenic medications such as, methotrexate , corticosteroids etc. * patients suffering from other diseases that could increase alt levels eg. viral hepatitis, hiv, autoimmune liver diseases, infiltrative liver diseases. * patients suffering from malignancies. * patients who are not compliant to the medicine. * pregnant and nursing females
s9804: vinorelbine in treating patients with stage iv melanoma

Conditions: Melanoma (Skin)

Summary: rationale: drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. purpose: phase ii trial to study the effectiveness of vinorelbine in treating patients who have stage iv melanoma that has been previously treated.

objectives: i. evaluate the response rate (complete or partial) of patients with disseminated stage iv melanoma treated with vinorelbine. ii. assess the qualitative and quantitative toxic effects of vinorelbine in these patients. outline: patients receive vinorelbine by iv over 6 to 10 minutes weekly. treatment continues in the absence of disease progression, unacceptable toxicity, or complete response to therapy. patients are followed every 3 months for 2 years and every 6 months thereafter. projected accrual: a total of 20-40 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: histologically confirmed, pathologically verified, disseminated stage iv melanoma that is surgically incurable any t, any n, m1a or m1b must have received at least one prior chemotherapy, biologic/immunotherapy, or combination regimen for metastatic disease at least 4 weeks since prior systemic therapy bidimensionally measurable disease by physical exam, ct scan, radionuclide scan, or plain x-ray outside previously irradiated area no brain metastases by mri or ct scan (except completely resected brain tumors that have undergone whole brain radiotherapy) patient characteristics: age: not specified performance status: swog 0-2 life expectancy: not specified hematopoietic: not specified hepatic: not specified renal: not specified other: hiv negative not pregnant or nursing fertile patients must use effective contraception no other prior malignancy within the past 5 years, except: adequately treated basal cell or squamous cell skin cancer adequately treated stage i or ii cancer carcinoma in situ of the cervix prior concurrent therapy: biologic therapy: see disease characteristics at least 4 weeks since prior adjuvant biologic or immunotherapy chemotherapy: see disease characteristics no prior adjuvant chemotherapy endocrine therapy: not specified radiotherapy: at least 4 weeks since prior radiotherapy surgery: at least 4 weeks since prior surgery

Keywords: stage iv melanoma recurrent melanoma
the feasibility, usability, and acceptability of using the oculus™ virtual reality gaming technology in stroke survivors for upper extremity and cognitive rehabilitation

Conditions: Stroke

Summary: the purpose of this study is to test the (a) feasibility, (b) usability, and (c) acceptability of using the oculus virtual reality (vr) for chronic stroke survivors who have mild-moderate cognitive and unilateral arm impairment to administer upper extremity and cognitive rehabilitation, to calculate the change in upper extremity and cognition scores on standardized measurements per standard of care and to qualitatively explore the impact of engaging caregivers in supporting the stroke survivor's rehabilitation and the impact of this engagement on the stroke survivor and caregiver dyad using semi-structured interviews.


Eligibility criteria:
inclusion criteria: * ischemic or hemorrhagic stroke diagnosis within 6 months to 2 years of enrollment * can read, write, comprehend, speak english * willing and able to provide informed consent * caregivers must live in the home with the stroke survivor exclusion criteria: * do not have score ranges that indicate mild to moderate severity on the montreal cognitive assessment (moca )(15-25) or other appropriate cognitive screening test selected by the speech language pathologist * has aphasia, hemiopsia, and other neurological deficits that prevents the participant from being examined using moca or a modified moca, fugl-meyer assessment - upper extremity (fm) (20-50) * unstable while standing unassisted * have a history of motion sickness/ vertigo/ dizziness/seizures, claustrophobia, blind/deaf, and cannot hold the controller in their affected arm.

Keywords: rehabilitation upper limb stroke survivor
immunostimulating interstitial laser thermotherapy in solid cancers

Conditions: Neoplasms

Summary: thermotherapy is a technology aiming at destroying tissue, for example tumor tissue. immunostimulating interstitial laser thermotherapy (imilt) is a specific form of thermotherapy, which, in addition to destroying tumor tissue, has been optimized to cause a tumor specific immunologic response. in laboratory animals the imilt method has also been shown to induce a so called abscopal effect. this means that when one tumor is treated with imilt other, untreated, tumors also decrease in size. the immunologic response has previously been characterized in breast cancer patients after receiving imilt treatment , and presumed abscopal effects induced by imilt have also been described in a malignant melanoma patient. the purpose of this trial is to evaluate efficiency when it comes to local tumor destruction of the imilt treatment method in patients diagnosed with solid tumors. the purpose is also to investigate the functionality and safety as well as understanding of the subsequent immunological effects. since immunologically based treatment of various solid tumors is under intense review with so called "immune checkpoint inhibitors" this trial will also provide valuable information on how imilt, in the future, could be combined with these new and, for some patients, very effective treatment regimens. the treatment method has successfully been used for treatment of patients with breast cancer and malignant melanoma. treatment of breast cancer patients caused an increase of cytotoxic t lymphocytes in the treated tumor, as well as activated dendritic cells at the tumor border. regulatory t lymphocytes decreased in the regional lymph nodes. this trial is explorative, prospective, open and non-randomized. thirty patients diagnosed with solid tumors will be treated in this trial, which is estimated to be carried out during a time period of 18 months.


Eligibility criteria:
inclusion criteria: * are male or female \> 18 years of age * have histologically confirmed, locally uncontrolled, solid cancer, with or without metastases, that cannot be treated surgically due to unresectability or inoperability * have one or more tumours assessable by mri/ct or ultrasound and situated in such a way that at least a part of the tumour can be treated with imilt without damage to surrounding vital structures or the skin * are candidates for ablative intervention also outside this study * have given informed verbal and written consent to participation in the trial * have an ecog performance status \ 60%) * have stable haematologic, renal and hepatic functions exclusion criteria: * are hiv positive * have an active autoimmune disease * are on systemic corticosteroid medication (local treatment with aerosol's and ointment is allowed) * have known bleeding disorders or are treated with anticoagulant medication * are pregnant or nursing

Keywords: hyperthermia, induced laser coagulation laser therapy
evaluation of the control level of asthmatic patients with seasonal increase of respiratory symptoms (high and/or low)

Conditions: Asthma; Respiratory Symptoms

Summary: to evaluate the level of control of asthma (gina : controlled, partially controlled, not controlled) of asthmatic patients consulting their general practitioner for a seasonal increase of respiratory symptoms (high and / or low) whether an inhaled corticotherapy is taken or not.


Eligibility criteria:
inclusion criteria: * asthmatic adults consulting for a seasonal increase of respiratory symptoms (high/low) and treated with prn fast acting bronchodilator alone or associated with inhaled igcs, excluding all other treatments for asthma.

Keywords: asthma seasonal respiratory symptoms asthmatic patients with increase of respiratory symptoms
hrt on overactive bladder symptoms, sexual function, depressive symptoms, autonomic function, and arterial stiffness

Conditions: Menopausal Syndrome

Summary: therefore, the aim of this study is to assess the therapeutic effect on overactive bladder symptoms, sexual function, heart rate variability, arterial stiffness, atherosclerosis, sleep, and depression between tibolone and e2v/mpa. from the results, the investigators will compare the effect of tibolone versus e2v/mpa on overactive bladder symptoms, sexual function, autonomic function, arterial stiffness, atherosclerosis, sleep and depression.

menopausal syndromes include overactive bladder symptom, autonomic symptoms, and even sexual dysfunction. hormone therapy (ht) is widely used for controlling menopausal symptoms. common ht for menopausal syndrome with intact uterus includes tibolone, estradiol valerate (e2v) 1mg \& medroxyprogesterone acetate (mpa), and conjugated equine estrogens (cee) \& mpa. however, only a few literatures mentioned about the therapeutic effect of tibolone, but lack of comparison research about their therapeutic effect on overactive bladder symptoms, sexual function, heart rate variability, arterial stiffness, atherosclerosis, sleep and depression. the knowledge of the above therapeutic effects should be important for choosing a suitable medication. therefore, the aim of this study is to assess the therapeutic effect on overactive bladder symptoms, sexual function, heart rate variability and arterial stiffness between tibolone and e2v/mpa. all female patients with intact uterus who underwent treatment for menopausal syndrome at far eastern memorial hospital from october 2021 will be included. an open-labeled, prospective, comparative study design will be used. ht included tibolone (2.5 mg/day) or e2v (1mg) \& mpa (2.5 mg) per day. the enrolled women will be requested to complete the greene climacteric scale, urgency severity scale, overactive bladder symptom score, the international prostate symptom score (ipss), the female sexual function index (fsfi), the pittsburgh sleep quality index, center for epidemiological studies depression questionnaire, heart rate variability, arterial stiffness and atherosclerosis examinations at baseline, and 4 weeks (visit 2) and 12 weeks (visit 3) after treatment. from the results, the investigators will compare the effect of tibolone versus e2v/mpa on overactive bladder symptoms, sexual function, autonomic function, arterial stiffness, atherosclerosis, sleep and depression. currently, there is no similar research as our current study.

Eligibility criteria:
inclusion criteria: * \>20 years old female * menopausal symptoms, still have a uterus, and no breast or other cancers, and no vascular-blocking disease such as stroke. exclusion criteria: * nil.
clinical characteristics and associations of the "good fontan" patient

Conditions: Congenital Heart Disease; Single-ventricle

Summary: this study aims to determine what are some of the clinical characteristics and associations of fontan patients who are doing well, as well as how accurate cardiology providers are at predicting the likelihood of future adverse event in their fontan patients.

this is a multi-center prospective study that involves collecting data from patients as well as their cardiology providers in order to determine whether there is correlation between patient-reported quality of life assessments and clinician-identified assessments of their patients. the study also involves collecting data from the medical records of participating patients and entering it into our study database.

Eligibility criteria:
inclusion criteria: * extracardiac or lateral funnel fontan exclusion criteria: * currently being evaluated for or listed for cardiac transplant * underwent fontan revision or conversion * currently pregnant

Keywords: fontan single ventricle