Kornimate/medical-research-clean huggingface dataset:
pain assessment in patients with chronic obstructive pulmonary disease (copd) exacerbations.

Conditions: Chronic Obstructive Pulmonary Disease

Summary: the prevalence of chronic obstructive pulmonary disease (copd) is between 8 and 12% of the adult population. this prevalence is expected to increase over the coming decades due to the aging of the population and the continued exposure to risk factors for the disease. the evolution of copd is marked by the occurrence of exacerbations of varying severity and patients are frequently admitted to the emergency department for evaluation, treatment and / or hospitalization. admission in emergency department for copd exacerbation represents approximately 1% of emergency admission. chronic pain is common in patients with chronic obstructive pulmonary disease (copd). the pain intensity may increase during acute episodes of exacerbations. this study is aimed to compare pain intensity during exacerbation and stable phase of patients with chronic obstructive pulmonary disease (copd).

chronic pain is common in patients with chronic obstructive pulmonary disease (copd). the pain intensity may increase during acute episodes of exacerbation. fifty (50) patients in acute exacerbation of copd will be included in the emergency department of chu grenoble alpes and hôpital du sacré coeur de montréal. the intensity and characteristics of pain will be evaluated from the short-form mcgill pain questionnaire (sf-mpq) and the brief pain inventory (bpi). assessment of respiratory status, anxiety and depression, and clinical and biological data, defining the severity of exacerbation, will also be collected. a 30-day follow-up visit, after a return to the stable state of copd, allowed the realization of respiratory functional exploration and the same questionnaires.

Eligibility criteria:
inclusion criteria: * ≥ 40 years * smoking at least ≥ 10 pack years * previous fev / fvc \<0.70 post bronchodilator * admitted for exacerbations (gold definition) exclusion criteria: * a dementia or non-communicating patient * patient with chronic pain of neoplastic origin or severe trauma (fracture , dislocation or severe pain) within 15 days before the date of inclusion * patient with no social security insurance , with restricted liberty or under legal protection * pregnant woman parturient or nursing

Keywords: copd, pain, exacerbation
continuous endostar infusion combined with radiotherapy in patients with brain metastases

Conditions: Brain Metastases

Summary: the aim of this study is to evaluate the clinical efficacy and safety of continuous endostar infusion combined with radiotherapy for treatment of brain metastases.


Eligibility criteria:
inclusion criteria: * histologically confirmed malignancy with presence of intraparenchymal brain metastases * karnofsky performance status ≥ 40 * measurable disease according to recist criteria * hematologic function: wbc ≥ 4.0×109/l, plt ≥ 80×109/l, hb ≥ 90g/l * renal function: cr ≤ 2.0×uln * hepatic function: bil ≤ 2.0×uln, alt/ast ≤ 5.0×uln * adequate cardiac function * life expectancy ≥ 3 months exclusion criteria: * evidence of bleeding diathesis or serious infection * serious cardiovascular disease (congestive heart failure, uncontrollable arrhythmia, unstable angina, myocardial infarction, serious heart valve disease, resistant hypertension) * uncontrollable mental and nervous disorders * pregnant or lactating women

Keywords: endostar radiotherapy brain metastases
use of an electronic medical record in the primary care setting to improve herpes zoster vaccination rates

Conditions: Herpes Zoster Disease

Summary: despite the significant benefits of herpes zoster vaccine (hzv), vaccination rates remain low. electronic medical records (emr) can serve as a practical strategy to better facilitate the application of preventative health care, such as increasing immunization rates. a new care model that can increase the herpes zoster vaccination rate, as well as other preventative health services, is warranted. the objective of this study is to investigate if the functions of an emr, in combination with a pharmacist as part of the care team, can improve the herpes zoster vaccination rate.


Eligibility criteria:
inclusion criteria: * greater than 60 years of age exclusion criteria: * documented herpes zoster vaccine in the emr

Keywords: herpes zoster vaccine electronic patient portal electronic medical record primary care immunizations
efficacy and compliance of the mandibular advancement devices oniris® vs. custom made devices

Conditions: Obstructive Sleep Apnea

Summary: to evaluate the efficacy (non-inferiority) in terms of response between patients using custom fitted mandibular advancement devices oniris® and patient using laboratory custom made devices tali, after 2 months of use. sleeping tests were performed.

open, non-inferiority, controlled and rndomised clinical trial. six months of inclusion. each included patient will be followed during 12 months.

Eligibility criteria:
inclusion criteria: * patients with severe syndrome of obstructive sleep apnea and hypopneas refusing or withdrawal from continuous positive pression ventilation * no dental, paro-dental or articular contraindication * patients never treated by mandibular advancement devices exclusion criteria: * severe psychiatric or neuromuscular disorders appreciated by the investigator * more than 20% of apneas and central hypoapneas * severe syndrome of obstructive sleep apnea and hypopneas with iah \> 30% associated with another sleeping pathology * bmi \> 30kg/m2 * patient with an uncontrollable nausea reflex * epileptic patients * pregnant patients * patient without written informed consent

Keywords: mandibular advancement devices oniris® obstructive sleep apnea and hypopneas
the application of ketamine for sedation in patients with cardiac arrest - - ketcat (ketamine in cardiac arrest) study

Conditions: Cardiac Arrest, Out-Of-Hospital; Ketamine; Neurologic Manifestations

Summary: recent evidence suggests ketamine may attenuate harmful cellular cascades taking place after brain injury that result in permanent damage. the investigators are interested in researching the application of this in the setting of cardiac arrest. following cardiac arrest, the brain is deprived oxygen for a period of time, leading to the imitation of these harmful cellular processes. the investigators hypothesize that patients who receive ketamine as part of their standard sedation procedures during cardiac arrest treatment have better neurological functioning compared to those who do not.


Eligibility criteria:
inclusion criteria: * all out-of-hospital cardiac arrests (ohca) with a "shockable rhythm" (ventricular fibrillation, pulseless ventricular tachycardia) that present to the royal columbian hospital. the patient may be either in active cardiac arrest with shockable rhythm or may have achieved return of spontaneous circulation (rosc). * over 19 years of age * patients requiring sedation based on the assessment of the resuscitating physician. exclusion criteria: * any other type of cardiac arrest * any history of previous, pre-existing neurological deficit * started on extracorporeal membrane oxygenation (ecmo) * duration of cardiac arrest without rosc is greater than 30 consecutive minutes * known contraindication or hypersensitivity to ketamine * awake patient or no standard sedation or no intubation required * inability to obtain deferred consent * currently enrolled in any other research study involving drugs or devices * patients who are pregnant * patients who are prisoners * patients residing in long term care (ltc) facilities

Keywords: pilot study single-centre
veteran stress and learning study

Conditions: Stress Disorders, Posttraumatic

Summary: this is a research study examining the use of two medications, hydrocortisone and d-cycloserine, compared to an inactive substance (placebo), on their ability to reduce fear responses and memory of fear in veterans with symptoms of posttraumatic stress disorder (ptsd). these responses will be tested using a fear learning and memory task administered by computer.


Eligibility criteria:
inclusion criteria: * veterans and civilians with an age range of 18 to 65 years * participants must be physically healthy volunteers exclusion criteria: * individuals who fall outside the age range * individuals with medical conditions that would interfere with participation * other criteria

Keywords: stress disorders, posttraumatic hydrocortisone cycloserine extinction, psychological ptsd san francisco
utilizing blood volume measurements in the treatment of heart failure patients

Conditions: Congestive Heart Failure

Summary: this will be a clinical test to determine if using blood volume measurements (bvm) to help guide fluid removal with ultrafiltration in patients hospitalized with decompensated heart failure leads to improved outcomes.

subjects will be randomized into two groups. in the control group, the treating physician will not see the blood volume measurement results. in the experimental group, the physician will be given the blood volume measurement results. ultrafiltration is performed based on the results of blood volume measurement in the experimental group followed by repeat blood volume analysis after 30 minutes of the completion of ultrafiltration. clinical and laboratory assessment as per the standard of care will be used to assess overall fluid status, and blood volume measurement results will be used as the assessment of intravascular fluid. these assessments will be used to determine a goal quantity of fluid to be removed. all subjects will return for a clinical assessment at 30 and 90 days and laboratory data will be drawn at that time to evaluate renal functional indices, electrolytes and blood volume measurements.

Eligibility criteria:
inclusion criteria: * primary diagnosis of heart failure * \>/= 2 criteria of volume overload 1. jvd \> 7 cm 2. ascites 3. lower extremity edema 4. sacral edema 5. pleural effusion by clinical or radiologic criteria * ckd 3 or worse renal function clcr \< 60 ml/min * hct \< 40% * serum albumin \>/= 2.5 gm/dl

Keywords: congestive heart failure ultrafiltration blood volume measurement
cep249 pediatric accuracy study

Conditions: Insulin Requiring Diabetes

Summary: the purpose of this study is to evaluate the enlite sensor™ and enlite 3 sensor performance in pediatric patients with insulin requiring diabetes at the beginning, middle and end of sensor wear.

this study is a prospective, single arm, multi-center, in-clinic study.. there will be two consecutive phases of the study: a total of up to 260 subjects (2-18 years old) will be enrolled at up to 15 investigational centers subjects will come for clinic visit for ysi reference glucose testing and for enlite sensor™ and enlite 3 sensor™ testing. smbg (self-monitoring of blood glucose) reference measurement is for subjects 2-6 years of age and cannot tolerate ysi. study has a run-in period and a study period with a total of 10 visits

Eligibility criteria:
inclusion criteria: 1. subject is 2-18 years of age at time of screening 2. subject has been diagnosed with insulin requiring diabetes mellitus for at least one year. 3. subject is willing to perform greater than or equal to 4 finger stick blood glucose measurements daily 4. subject is willing to perform required sensor calibrations 5. subject is willing to wear the system (guardian mobile application, pumps, sensors, meter) continuously throughout the study 6. adequate venous access as assessed by investigator or appropriate staff exclusion criteria: 1. subject is unable to tolerate tape adhesive in the area of sensor placement 2. subject has any unresolved adverse skin condition in the area of sensor or device placement (e.g., psoriasis, rash, staphylococcus infection) 3. subject is actively participating in an investigational study (drug or device) wherein they have received treatment from an investigational study (drug or device) in the last 2 weeks 4. females of child-bearing potential who have a positive pregnancy test at screening or plans to become pregnant during the course of the study 5. subjects with hematocrit lower than the normal age specific reference range per central or local lab testing

Keywords: insulin requiring diabetes children sensor accuracy
home versus hospital based niv care in mnd

Conditions: Motor Neurone Disease; Respiratory Insufficiency

Summary: non-invasive ventilation (niv) is commonly offered to people with motor neurone disease (mnd) who have breathing difficulties. it improves their quality of life and can prolong life by 6 months or more. it is initially used at night and typically set up during a hospital admission. by the time that they develop respiratory failure and need to start niv, however, most patients require wheelchairs or have other significant health problems. repeated travel to hospitals is increasingly difficult with increasing disability. it is possible to start and monitor niv treatment at home. this may be more convenient for selected patients, though starting niv is quite complex; it is not known if home treatment is as safe and effective as hospital-based treatment. to establish this, 60 patients with mnd who have indications for niv will be recruited. they will be randomly allocated to a home-based treatment (home niv set up plus home visits supported by telemonitoring) or hospital-based care (inpatient niv set up plus outpatient niv monitoring) and followed up at 1, 4 and 7 months. alongside measures of treatment effectiveness, assessment of patient and carer preferences, quality of life, and cost-effectiveness will be undertaken. in the additional qualitative part on this study, interviews with patients who took part in the main study and their carers will be conducted to understand in more depth their perspective on what makes for a good or bad experience with niv, how the environment (home vs hospital) influences their niv experience and what personal factors determine niv use. findings from the interviews will inform the design of a truly patient-centred niv service.


Eligibility criteria:
inclusion criteria: * adults with a diagnosis of motor neurone disease confirmed by a neurologist specialising in mnd. * indications to niv: daytime pco2 \>6.0 kpa or/and symptoms of ventilatory failure (e.g. orthopnoea, paroxysmal nocturnal dyspnoea, morning drowsiness) in the presence of significant diaphragmatic weakness confirmed by respiratory muscle tests exclusion criteria: * cognitive impairment precluding understanding of the study protocol and valid consent * severe co-morbidities (e.g. decompensated heart failure, severe chronic obstructive pulmonary disease (copd), morbid obesity) causing or contributing to respiratory failure * immediate need to start niv (\<24hrs) and/or acute illness requiring inpatient treatment e.g. intravenous antibiotics for pneumonia (in addition to the need for niv) * lack of a sufficient social/professional network to support niv application at home * not wishing to accept home niv

Keywords: non invasive ventilation
detection rate of serrated adenomas in screening colonoscopy

Conditions: Healthy Patients Undergoing Screening Colonoscopy

Summary: an observational prospective will be conducted to determine the detection rate of serrated adenoma during screening colonoscopy at our institution. additionally, the variability of serrated adenoma detection among endoscopists will be evaluated and the characteristics of serrated adenomas will be described.

colonoscopy screening is a preventative measure for colorectal carcinoma (crc), a highly malignant and dangerous cancer. extensive research on the adenoma detection rate has provided national standards and quality metrics to help assess competence of endoscopists. currently, there are no standards established for serrated adenomas. the proposed study would be conducted at good samaritan hospital (gsh) and trihealth surgery center west. this is an observational study and does not involve any patient interventions. however, because patient healthcare data will be collected for research, informed consent will be obtained shortly before the procedure. the main study objective is to determine the detection rate of serrated adenoma during screening colonoscopy at our institution. additionally, the variability of serrated adenoma detection among endoscopists will be evaluated and the characteristics of serrated adenomas will be described.

Eligibility criteria:
inclusion criteria: * males and females exclusion criteria: * first degree relative (patient's parent, sibling or child) diagnosed with colorectal carcinoma at age of 59 or under * new onset of iron deficiency anemia (within past 3 months) * abnormal imaging of colon within past 3 months * inadequate visualization reported by endoscopist * pregnant women

Keywords: serrated adenoma, colonoscopy
prospective randomized blinded trial of versawrap tendon protector for zone 2 flexor tendon injuries

Conditions: Flexor Tendon

Summary: to analyze outcomes between patients with z2ft injuries following repair, randomized to two groups. the first group will be the negative control, with no tendon wrap. the second group will have a versawrap tendon protector applied over the site of the tendon repair. versawrap is current soc at uf.

versawrap tendon protector is intended to manage and protect tendon injuries where there is no significant loss of tendon tissue. it functions by separating the healing tendon from surrounding tissues to facilitate tendon gliding and tendon healing. versawrap can be placed on, over, or around flexor tendons and remains in place until healing is complete and then is bioresorbed. versawrap is fda cleared for the use in procedures where there is no significant loss of tendon tissue and is currently one of the standard of care treatments used for this injury at uf health. versawrap tendon protector includes a bioresorbable hydrogel sheet and a wetting solution. the sheet is transparent, flexible, ultrathin, non-sided, and can be cut to the desired size. it is made of polysaccharides alginate and hyaluronic acid. tendon adhesions are a major problem following repair, particularly for zone 2 flexor tendon (z2ft) lacerations. the purpose of this study is to prospectively analyze outcomes between patients with z2ft injuries following repair, randomized to two groups. the first group will be the negative control, with no tendon wrap. the second group will have a versawrap tendon protector applied over the site of the tendon repair. outcomes will be evaluated during standard of care post-operative clinic visits at 2 (+/-10 days) weeks, 6 weeks (+/-2 weeks) and 3 months (+/- 1 month) following surgery. data will be collected from standard of care measurements that include the following outcome measures that will be performed at each follow up visit: range of motion of the affected finger at different joints; total active motion (tam) of the finger; strickland modification of tam (only including proximal interphalangeal (pip); and distal interphalangeal (dip) joints), as well as, dash score and michigan hand outcomes questionnaire. a measurement of grip strength will be obtained at the 3 month follow up visit. this is an important study as adhesions are a particularly serious problem following repair of z2ft injuries, which can result in persistent finger stiffness and decreased range of motion reducing the quality of life.

Eligibility criteria:
inclusion criteria: * adult patients presenting to the plastic surgery service with a zone 2 flexor tendon injury requiring surgical repair exclusion criteria: * patients with a sensitivity or allergy to polysaccharides alginate, hyaluronic acid, or citrate * patients with psychiatric or medical problems that preclude them from having surgery * female patients that are pregnant or breastfeeding * prisoners * patients who are unwilling or unable to follow-up
anesthetic optimization in scoliosis surgery

Conditions: Adolescent Idiopathic Scoliosis; Respiratory Depression; Postoperative Pain

Summary: the standard anesthetic care plan for people having adolescent idiopathic scoliosis surgery will be accompanied by a pharmacokinetic simulation of the administered drugs to suggest opportunities to adjust drug doses to achieve tolerable pain control after surgery, avoid respiratory depression and allow patients to respond quickly either during intraoperative testing or at the conclusion of surgery.

as part of this study, anesthesiologists will be given additional data on the expected drug effects based on a computer simulation. the data will be provided as a suggestion and will be used together with all the other information normally used to keep the study subjects safely asleep during surgery. in addition, data will be collected from the medical history and on postoperative pain control and medication side effects for the first 24 hours. specifically, study subjects will be asked to rate their pain on a 10-point scale after they wake up from surgery and once they arrive in the pediatric intensive care unit. measures of the time from the end of surgery until the study subjects are awake and out of the operating room will also be collected.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists (asa) class 1-2 * at least 10 years of age and not older than 18 years of age * diagnosis of idiopathic adolescent scoliosis exclusion criteria: * currently pregnant * currently breastfeeding * currently being treated with opiates * currently being treated with alpha2 agonists * currently being treated with anticonvulsants * currently being treated with antidepressants * history of significant restrictive lung disease

Keywords: adolescent idiopathic scoliosis scoliosis surgery pharmacokinetic simulation